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Amanda Sacker, PhD, Richard D. Wiggins, PhD, Mel Bartley, PhD and Peggy McDonough, PhD

Amanda Sacker and Mel Bartley are with the Department of Epidemiology and Public Health, University College London, England. Richard D. Wiggins is with the Department of Sociology, City University, London. Peggy McDonough is with the Department of Public Health Sciences, University of Toronto, Toronto, Ontario.

Correspondence: Requests for reprints should be sent to Amanda Sacker, PhD, Dept of Epidemiology and Public Health, University College London, 1–19 Torrington Pl, London, WC1E 6BT, UK (e-mail: a.sacker{at}ucl.ac.uk).

Objectives. We reviewed literature on comparative social policy and life course research and compared associations between health and socioeconomic circumstances during an 11-year period in the United States and the United Kingdom.

Methods. We obtained data from the US Panel Study of Income Dynamics and the British Household Panel Survey (1990–2002). We used latent transition analysis to examine change in self-rated health from one discrete state to another; these health trajectories were then associated with socioeconomic measures at the beginning and at the end of the study period.

Results. We identified good and poor latent health states, which remained relatively stable over time. When change occurred, decline rather than improvement was more likely. UK populations were in better health compared with US populations and were more likely to improve over time. Labor market participation was more strongly associated with good health in the United Kingdom than in the United States.

Conclusions. National policies and practices may be keeping more US workers than UK workers who are in poor health employed, but British policies may give UK workers the chance to return to better health and to the labor force.

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