Article Text

Download PDFPDF
Social dynamics of health inequalities: a growth curve analysis of aging and self assessed health in the British household panel survey 1991–2001
  1. Amanda Sacker1,
  2. Paul Clarke1,
  3. Richard D Wiggins2,
  4. Mel Bartley1
  1. 1Department of Epidemiology and Public Health, Royal Free and University College London Medical School, London, UK
  2. 2Department of Sociology, City University London, London, UK
  1. Correspondence to:
 Dr A Sacker
 Department of Epidemiology and Public Health, Royal Free and University College London Medical School, 1–19 Torrington Place, London WC1E 6BT, UK;


Objectives: To study how social inequalities change as people age, this paper presents a growth curve model of self assessed health, which accommodates changes in occupational class and individual health with age.

Design: Nationally representative interview based longitudinal survey of adults in Great Britain.

Setting: Representative members of private households of Great Britain in 1991.

Participants: Survey respondents (n = 6705), aged 21–59 years in 1991 and followed up annually until 2001.

Main outcome measure: Self assessed health.

Results: On average, self assessed health declines slowly from early adulthood to retirement age. No significant class differences in health were observed at age 21. Health inequalities emerged later in life with the gap between mean levels of self assessed health of those in managerial and professional occupations and routine occupations widening approaching retirement. Individual variability in health trajectories increased between ages 40 and 59 years so that this widening of mean differences between occupational classes was not significant. When the analysis is confined to people whose occupational class remained constant over time, a far greater difference in health trajectories between occupational classes was seen.

Conclusions: The understanding of social inequalities in health at the population level is enriched by an analysis of individual variation in age related declines by social position.

  • SAH, self assessed health
  • BHPS, British household panel survey
  • GCM, growth curve model
  • NS-SEC, National Statistics Socio-economic Classification
  • growth curve models
  • self assessed health

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: this work was funded as part of the Medical Research Council’s “Health of the Public” initiative. Grant number: 9900586. Mel Bartley’s work on the paper was supported by ESRC Fellowship award R 000 27 1112.

  • Conflicts of interest: none declared.

Linked Articles

  • In this issue
    Carlos Alvarez-Dardet John R Ashton