American Journal of Public Health, Vol 91, Issue 2 277-283, Copyright © 2001 by American Public Health Association

JOURNAL ARTICLE

Do socioeconomic disadvantages persist into old age? Self-reported morbidity in a 29-year follow-up of the Whitehall Study

E Breeze, AE Fletcher, DA Leon, MG Marmot, RJ Clarke and MJ Shipley
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Steet, London, WC1E 7HT England. elizabeth.breeze@lshtm.ac.uk

OBJECTIVES: This study examined (1) the relation of employment grade in middle age to self-reported poor health and functional limitations in old age and (2) whether socioeconomic status at approximately the time of retirement modifies health differentials in old age. METHODS: Survivors of the Whitehall Study cohort of men were resurveyed. Respondents were aged 40 to 69 years when they were originally screened in 1967 to 1970. RESULTS: Compared with senior administrators, men in clerical or manual (low-grade) jobs in middle age had quadruple the odds of poor physical performance in old age, triple the odds of poor general health, and double the odds of poor mental health and disability. At most, 20% of these differences were explained by baseline health or risk factors. Men who moved from low to middle grades before retirement were less likely than those who remained in low grades to have poor mental health. CONCLUSIONS: Socioeconomic status in middle age and at approximately retirement age is associated with morbidity in old age.

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