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Issue 6, July 2000, pp.4.

Reports from the Programme conference:
Health inequalities from a lifecourse perspective
Chris Power

It has been known for some time that disease risks tend to cluster according to socio-economic group, but only recently have we begun to appreciate the extent to which risks accumulating over long periods of life contribute to the development of health inequalities. Important new studies of mortality show that early life factors are influential for some causes of death and not others. But what of health and well-being during life, at stages that are relatively healthy for most people? Are there inequalities in health in early adulthood and, if so, what are the causes?

This presentation described socio-economic trends in health among 33 year-olds in the 1958 British birth cohort and traced the origins of these inequalities. It used three measures of health status: obesity, psychological distress and the individual's self-assessment that their health was poor or fair. Differences in health were pronounced, e.g. 19% of women in unskilled manual social classes rated their health as poor, compared with 9% in professional and managerial classes. Although it might have been expected that self-assessed health and psychological distress were due to influences over the short-term, in fact the explanations for inequalities appeared to reside in early life as well as in contemporary circumstances. The predominant pattern was a strong social differentiation of accumulated risks onwards from birth. Factors identified suggested a key role for material circumstances and associated acquisition of socio-emotional skills and resources in childhood, as well as for adult health behaviours and work-related experience. In contrast, preliminary findings suggested that inequalities in adult obesity may be due to early life conditions or to a synergistic relationship between early life and current factors. Given that the selected health measures are indicators of both current and future health status, the trends and likely origins observed here may well foreshadow those for future inequalities in mortality.