Social dynamics of health inequalities: a growth curve analysis of aging and self assessed health in the British household panel survey 1991-2001.

OBJECTIVES

To study how social inequalities change as people age, this paper presents a growth curve model of self assessed health, which accommodates changes in occupational class and individual health with age.

DESIGN

Nationally representative interview based longitudinal survey of adults in Great Britain.

SETTING

Representative members of private households of Great Britain in 1991.

PARTICIPANTS

Survey respondents (n = 6705), aged 21-59 years in 1991 and followed up annually until 2001.

MAIN OUTCOME MEASURE

Self assessed health.

RESULTS

On average, self assessed health declines slowly from early adulthood to retirement age. No significant class differences in health were observed at age 21. Health inequalities emerged later in life with the gap between mean levels of self assessed health of those in managerial and professional occupations and routine occupations widening approaching retirement. Individual variability in health trajectories increased between ages 40 and 59 years so that this widening of mean differences between occupational classes was not significant. When the analysis is confined to people whose occupational class remained constant over time, a far greater difference in health trajectories between occupational classes was seen.

CONCLUSIONS

The understanding of social inequalities in health at the population level is enriched by an analysis of individual variation in age related declines by social position.