The duration and timing of exposure: effects of socioeconomic environment on adult health.
C Power,
O Manor and
S Matthews
Department of Epidemiology and Public Health, Institute of Child Health, London, England. c.power@ich.ucl.ac.uk
OBJECTIVES: This study investigated timing and duration effectsof socioeconomic status (SES) on self-rated health at 33 yearsof age and established whether health risks are modified bychanging SES and whether cumulative SES operates through education.METHODS: Data were from the 1958 British birth cohort. Occupationalclass at birth and at 16, 23, and 33 years of age was used togenerate a lifetime SES score. RESULTS: At 33 years of age,12% of men and women reported poor health. SES at birth andat 16, 23, and 33 years of age was significantly associatedwith poor health: all ages except 16 years in men made an additionalcontribution to the prediction of poor health. No large differencesin effect sizes emerged, suggesting that timing was not a majorfactor. Odds of poor health increased by 15% (men) and 18% (women)with a 1-unit increase in the lifetime SES score. Strong effectsof lifetime SES persisted after adjustment for education level.CONCLUSIONS: SES from birth to 33 years of age had a cumulativeeffect on poor health in early adulthood. This highlights theimportance of duration of exposure to socioeconomic conditionsfor adult health.
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