title: Life course social roles and women's health in mid-life: causation or selection?
abstract: OBJECTIVE
  To investigate whether relations between social roles and health are explained by health selection into employment and parenthood by examining the influence of early health on relations between long term social role histories and health in mid-life.
  
  
  METHODS
  Prospective, population based, birth cohort study.
  
  
  METHODS
  Women from a national British cohort born in 1946, including 1171 women with a valid measure of self reported health at age 54 and valid work and family role measures at ages 26, 36, 43, and 53, as well as 1433 women with a valid body mass index (BMI) measure at age 53 and valid work and family role measures at ages 26, 36, 43, and 53.
  
  
  METHODS
  Self reported health at age 54 and obesity at age 53, taken from objective height and weight measures conducted by a survey nurse during face to face interviews in respondents' homes.
  
  
  RESULTS
  Women who occupied multiple roles over the long term reported relatively good health at age 54 and this was not explained by early health. Women with weak long term ties to the labour market were more likely to be obese at age 53. Examination of body mass index (BMI) from age 15 showed that long term homemakers were larger than other women from age 26, but their mean BMI increased significantly more with age than that of other women.
  
  
  CONCLUSIONS
  Relations between social roles and health were generally not explained by health selection into employment and parenthood, although some health selection may occur for obesity.
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. a.mcmunn@ucl.ac.uk
authors.forename: Anne
authors.initials: A
authors.lastname: McMunn
authors.forename: Mel
authors.initials: M
authors.lastname: Bartley
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012380:Role; D012931:Social Environment; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D016387:Women's Health