Introduction In long-term developed countries socioeconomic position across the life course is positively associated with health. We examined these associations in a developing country with a history of efforts to reorganise social hierarchy.

Methods Taking a life course perspective, we used multivariable logistic regression to analyse the association of socioeconomic disadvantage at four life stages (measured by parental possessions, education, longest-held occupation and current household income) with self-rated health in 19 203 Chinese adults aged ≥50 years from the Guangzhou Biobank Cohort Study (2005–2008). Model comparisons were used to determine whether the number of exposures to disadvantage (accumulation of risk) was more important than the life stage of exposure (critical periods).

Results Among men and women, socioeconomic disadvantage in childhood and currently was associated with poor health, as was disadvantage in early adulthood for men. Adjusting for adult health-related behaviour (smoking, alcohol use and physical exercise) altered these associations very little.

Conclusion Associations between socioeconomic disadvantage and health in this Southern Chinese population were broadly similar to those found in Western countries in terms of the accumulation of disadvantage across the life course. However, there were also important differences. In particular, occupation (in both sexes) and education (in women) were not independently associated with adult health. This suggests that the mechanisms linking socioeconomic position to health in China may be different from those in Western populations.