PATTERNS OF CLASS-INEQUALITY IN HEALTH THROUGH THE LIFE-SPAN - CLASS GRADIENTS AT 15, 35 AND 55 YEARS IN THE WEST OF SCOTLAND

Data confirming the existence of social inequalities in health have co ntinued to accumulate since the Black Report reported class inequaliti es across a broad range of causes of mortality, with an increasing emp hasis on indicators of morbidity and current health status. Although e vidence of continuing inequalities mounts, elucidation of underlying m echanisms generating and maintaining such inequalities has been more e lusive, and much of the debate has oscillated from the very broad to t he very specific. In this paper, the class patterning of a range of no n-fatal indicators of health are modelled in an attempt to outline fir st the adequacy of models of linear relationships for this range of me asures, and secondly, the extent to which these are generalizable acro ss a series of age/sex subgroups and across different domains of healt h. Data are presented here for representative community samples of men and women in adolescence, early- and late-midlife. While orderly rela tionships between social class and health were seen for the majority o f the measures considered; the detailed patterns show considerable div ersity. Thus for some aspects of health, notably height (itself often heralded as a broad indicator of health and early life experience), co mmon class gradients were observed for both sexes at each of the stage s of the life course examined. For others (notably mental health and p resence of chronic illness), gradients were evident in later life but not in adolescence. Others still showed sex but not age differences in class patterning (typically measures of body shape), or no clear patt erns (notably blood pressure and consultations with general practition ers). The current analysis draws attention to the consistency of gradi ents in early- and late-midlife, which are apparent despite the marked increase in the burden of poorer health which manifests between these life stages for almost all indicators of health (an exception being m ental health). The challenges which this presents for understanding th e mechanisms and processes which have been candidate explanations for social inequalities in health are discussed.