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August 2005, Vol 95, No. 8 | American Journal of Public Health 1403-1409
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.047969


RESEARCH AND PRACTICE

Socioeconomic Position and Self-Rated Health: The Contribution of Childhood Socioeconomic Circumstances, Adult Socioeconomic Status, and Material Resources

Mikko Laaksonen, PhD, Ossi Rahkonen, PhD, Pekka Martikainen, PhD and Eero Lahelma, PhD

Mikko Laaksonen and Eero Lahelma are with the Department of Public Health, Ossi Rahkonen is with the Department of Social Policy, and Pekka Martikainen is with the Population Research Unit, Department of Sociology, University of Helsinki, Helsinki, Finland.

Correspondence: Request for reprints should be sent to Mikko Laaksonen, Department of Public Health, P.O. Box 41, 00014, University of Helsinki, Finland (e-mail: mikko.t.laaksonen{at}helsinki.fi).

Objectives. We examined socioeconomic inequalities in self-rated health by analyzing indicators of childhood socioeconomic circumstances, adult socioeconomic position, and current material resources.

Methods. We collected data on middle-aged adults employed by the City of Helsinki (n=8970; 67% response rate). Associations between 7 socioeconomic indicators and health self-ratings of less than "good" were examined with sequential logistic regression models.

Results. After adjustment for age, each socioeconomic indicator was inversely associated with self-rated health. Childhood economic difficulties, but not parental education, were associated with health independently of all other socioeconomic indicators. The associations of respondents’ own education and occupational class with health remained when adjusted for other socioeconomic indicators. Home ownership and economic difficulties, but not household income, were the material indicators associated with health after full adjustment.

Conclusions. Own education and occupational class showed consistent associations with health, but the association with income disappeared after adjustment for other socioeconomic indicators. The effect of parental education on health was mediated by the respondent’s own education. Both childhood and adulthood economic difficulties showed clear associations with health and with conventional socioeconomic indicators.




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