Effects of income and wealth on GHQ depression and poor self rated health in white collar women and men in the Whitehall II study
- 1International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School and International Centre for Health and Society, London, UK
- 2Population Research Unit, Department of Sociology, University of Helsinki, Finland
- 3Department of Economics, University College London, London, UK
- 4Department of Social Medicine, University of Bristol, Bristol, UK
- Correspondence to: Dr P Martikainen, International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, 1–19 Torrington Place, London WC1E 6BT, UK;
- Accepted 25 November 2002
Study objective: To determine whether measures of income and wealth are associated with poor self rated health and GHQ depression.
Design: Whitehall II study of London based civil servants re-interviewed between 1997–1999; 7162 participants.
Main results: A twofold age adjusted difference in morbidity was observed between the top and bottom of the personal income hierarchy for both sexes. For household income and particularly for wealth these associations are stronger. After adjusting for health at baseline the associations between personal income and both health outcomes are reduced by about 40%–60%. For household income the attenuation is somewhat smaller and for wealth is about 30%. Adjusting for other sociodemographic factors leads to further attenuation of the effects.
Conclusions: The associations between income, particularly personal income, and morbidity can be largely accounted for by pre-existing health and other measures of social position. The strong independent association between household wealth—a measure of income earned over decades and across generations—and morbidity are likely to be related to a set of early and current material and psychosocial benefits.
Funding: the Whitehall II study has been supported by grants from the Medical Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36319), US, NIH; National Institute on Aging (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health. PM is supported by Academy of Finland (grant 70631, 48600) and the Gyllenberg Foundation. JF was supported by the Economic and Social Research Council (L128251046) during the preparation of this paper. MM is supported by a MRC Research Professorship.