Health selection operating between classes and across employment statuses.
BACKGROUND
The debate on health selection which describes the influence of health on subsequent social mobility is highly contested. The authors set out to examine the effect of health selection by looking at the effect of previous health status on changes in socio-economic position (SEP) over two time periods.


METHODS
Data were pooled from 13 waves (1991-2003) of the British Household Panel Survey (BHPS). Using a multilevel multinomial approach, the presence of health selection between classes and into/out of employment was concurrently tested and compared.


RESULTS
In the descriptive analysis, poor health was consistently associated with moving downward, while the outcome was inverse for upward movement. After accounting for the data structure using multilevel analysis, health was a predictor for social mobility when leaving and entering employment, but the effect was minimal for transitions between classes for both men and women.


CONCLUSIONS
The non-significant impact of health on mobility inside employment may reflect the presence of the significant impact of health on mobility between employment and non-employment. This implies that the effect of health was not evenly spread over all social mobility, but rather tends to concentrate on some types of mobility. The effect of each predictor on social mobility is more concentrated among specific transitions, and health and age were likely to be substantial in moving into/out of the labour force, whereas education was a relevant predictor for mobility into/out of upper classes, in particular, classes I/II.
Ki
Myung
M
UCL Institute of Child Health, University College London, 30 Guilford Street, London, UK. m.ki@ucl.ac.uk
Sacker
Amanda
A
Kelly
Yvonne
Y
Nazroo
James
J
D000328:Adult; D017677:Age Distribution; D002322:Career Mobility; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D006113:United Kingdom