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AJPH First Look, published online ahead of print Feb 5, 2009
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April 2009, Vol 99, No. 4 | American Journal of Public Health 680-689
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.141713


RESEARCH AND PRACTICE

Monitoring Inequities in Self-Rated Health Over the Life Course in Population Surveillance Systems

Catherine R. Chittleborough, GDPH, Anne W. Taylor, PhD, MPH, Fran E. Baum, PhD and Janet E. Hiller, PhD, MPH

Catherine R. Chittleborough and Janet E. Hiller are with the Discipline of Public Health, School of Population Health and Clinical Practice, University of Adelaide, Adelaide, Australia. Anne W. Taylor and Catherine R. Chittleborough are with the Population Research and Outcome Studies Unit, South Australian Department of Health, Adelaide. Fran E. Baum is with Flinders University of South Australia, Adelaide.

Correspondence: Requests for reprints should be sent to Catherine R. Chittleborough, Discipline of Public Health, School of Population Health and Clinical Practice, Level 9, 10 Pulteney St, mail drop 207, University of Adelaide, Australia, 5005 (e-mail: catherine.chittleborough{at}adelaide.edu.au).

Objectives. To investigate the effect of social mobility and to assess the use of socioeconomic indicators in monitoring health inequities over time, we examined the association of self-rated health with socioeconomic position over the life course.

Methods. Data came from a cross-sectional telephone survey (n = 2999) that included life-course socioeconomic indicators and from a chronic disease and risk factor surveillance system (n = 26 400). Social mobility variables, each with 4 possible intergenerational trajectories, were constructed from family financial situation and housing tenure during childhood and adulthood.

Results. Low socioeconomic position during both childhood and adulthood and improved financial situation in adulthood were associated with a reduced prevalence of excellent or very good health. Trends over time indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health.

Conclusions. Our results support policies aiming to improve family financial situation during childhood and housing tenure across the life course. Inclusion of life-course socioeconomic measures in surveillance systems would enable monitoring of health inequities trends among socially mobile groups.







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