Intragenerational social mobility and cause-specific premature mortality.

Sunnee Billingsley,Petri Böckerman

doi:10.1371/journal.pone.0211977

Abstract

This study explores whether there is a short-term relationship between intragenerational social mobility and mortality while individuals are working and whether it is widespread across different causes of death. Net of accumulated advantages and disadvantages, social mobility may influence mortality through health selection or changes in well-being. Men and women working in 1996 up to age 65 are observed annually until 2012 in Swedish register data. Time-varying covariates and origin and destination status are controlled for in discrete time event-history analyses. Results show that when men were upwardly mobile, mortality was lower due to cancer, CVD, IHD, and suicide. Upward mobility was only associated with lower odds of suicide for women. When downwardly mobile, cancer mortality was higher for both men and women and smoking-related cancer mortality was higher for men. Social mobility was not linked to deaths related to accidents and poisoning or alcohol-related mortality. The results may support a relationship between social mobility and mortality characterized by health selection: Only in the case of a chronic illness (cancer) was downward mobility associated with higher mortality. The widespread relationship between upward mobility and lower mortality for men may also indicate positive health selection into attaining a higher class and that individuals with poor health may be less likely to search for better positions or receive promotions.

Highlights

Developments in life course research have increasingly supported the idea that mortality risk is influenced by socioeconomic position in a cumulative process [1,2,3]
Mobile individuals have better mortality rates than those in their origin class but worse health than those in their destination class, and the reverse relationship appears for downwardly mobile individuals [4,5]. These findings are interpreted as evidence for two mechanisms that link mobility and mortality. They may indicate social selection [6]: poor health or health behavior leads to downward mobility, whereas good health promotes upward mobility
For working-aged adults who were employed in 1996, overall cancer and cardiovascular diseases (CVD) deaths are most common among both men and women, while causes of death related to accidents and poisoning and alcohol consumption are least common for both sexes

Summary

Introduction

Developments in life course research have increasingly supported the idea that mortality risk is influenced by socioeconomic position in a cumulative process [1,2,3]. Mobile individuals have better mortality rates than those in their origin class but worse health than those in their destination class, and the reverse relationship appears for downwardly mobile individuals [4,5] These findings are interpreted as evidence for two mechanisms that link mobility and mortality. They may indicate social selection [6]: poor health or health behavior leads to downward mobility, whereas good health promotes upward mobility. These findings may reflect social causation: individuals are exposed to health risks and benefits associated with the culture and environment of both classes [2,7].

Objectives

Methods

Results

Conclusion