Social inequality in physical and mental health comorbidity dynamics. 2009

Amanda Sacker, and Jenny Head, and David Gimeno, and Mel Bartley
Institute for Social and Economic Research, University of Essex, Colchester, UK. asacker@essex.ac.uk

OBJECTIVE To examine how socioeconomic position influences physical and mental health dynamics. METHODS The Whitehall II study of civil servants collected questionnaires on six occasions from 1991/93 to 2006/07. Civil service grade measured socioeconomic position and Short Form 36 General Health Survey component scores rated physical and mental health. Bivariate growth curve models of physical and mental health over 15 years were estimated for high, medium, and low grades (n = 8309). RESULTS At baseline, levels of physical and mental health were correlated for participants in low grades only. Among study participants in medium grades, mental health was maintained over time, even as physical health decreased. Restoring mental health after a negative response to poor physical health was more difficult for some in low grades. Recovery from downturns in physical health associated with poorer mental health also depended on better socioeconomic circumstances There was greater variability in baseline levels and rates of change in the mental and physical health of those in lower grades compared with higher grades. CONCLUSIONS Homeostatic mechanisms may vary by socioeconomic position. The greater variability of change in health function for those in lower grades implies considerable scope for improvement if sources of variation in health within disadvantaged groups that are amenable to intervention can be identified.

UI MeSH Term Description Entries
D008137 Longitudinal Studies Studies in which variables relating to an individual or group of individuals are assessed over a period of time. Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D008297 Male Males
D008603 Mental Health Emotional, psychological, and social well-being of an individual or group. Mental Hygiene,Health, Mental,Hygiene, Mental
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009790 Occupations Crafts, trades, professions, or other means of earning a living. Vocations,Occupation,Vocation
D010809 Physical Fitness The ability to carry out daily tasks and perform physical activities in a highly functional state, often as a result of physical conditioning. Fitness, Physical
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D005260 Female Females
D006304 Health Status The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. General Health,General Health Level,General Health Status,Level of Health,Overall Health,Overall Health Status,General Health Levels,Health Level,Health Level, General,Health Levels,Health Status, General,Health Status, Overall,Health, General,Health, Overall,Level, General Health,Levels, General Health,Status, General Health,Status, Health,Status, Overall Health

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