Monitoring Inequities in Self-Rated Health Over the Life Course in Population Surveillance Systems

Objectives. To investigate the effect of social mobility and to assess the use of socioeconomic indicators in monitoring health inequities over time, we examined the association of self-rated health with socioeconomic position over the life course. Methods. Data came from a cross-sectional telephone survey (n=2999) that included life-course socioeconomic indicators and from a chronic disease and risk factor surveillance system (n=26400). Social mobility variables, each with 4 possible intergenerational trajectories, were constructed from family financial situation and housing tenure during childhood and adulthood. Results. Low socioeconomic position during both childhood and adulthood and improved financial situation in adulthood were associated with a reduced prevalence of excellent or very good health. Trends over time indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. Conclusions. Our results support policies aiming to improve family financial situation during childhood and housing tenure across the life course. Inclusion of life-course socioeconomic measures in surveillance systems would enable monitoring of health inequities trends among socially mobile groups. (Am J Public Health. 2009;99:680-689. doi:10.2105/AJPH.2008.141713)