Socioeconomic factors and health in two generations of Norwegian women

Abstract

The effects of social determinants on health have been largely studied in men. There has also been a tendency to disregard historical context in studies of inequalities in health. This study assessed the effects of social determinants on women's health, especially those associated with the radical changes in their lives in the past 50 years, such as increased opportunities for higher education and employment. Data were examined from 2 health surveys of Norwegian women born either between 1926 and 1935 ("the housewife cohort") or between 1946 and 1955 ("the working mother cohort"), each cohort having experienced different historical periods of particular social transitions. Health had a social gradient in both the housewife cohort (N = 4546) and the working mother cohort (N = 6322), but somewhat dissimilarly. In both cohorts, self-rated health was poor with less education, lack of employment, and financial difficulties. Not having paid employment was associated with poor health in both cohorts, but contrary to our expectations, more so among the housewife cohort, in whom the association was stronger than in the working mother cohort. Women in managerial and manual occupations married to men higher on the occupational ladder assessed their health more favorably. This occupational position discrepancy suggested that women married to men in lower occupational positions assessed their health more negatively, in both cohorts, with the exception of professional women in the housewife cohort. Although socioeconomic influences on the 2 cohorts examined were considerably different, the fundamental social changes in women's lives in past decades were not reflected in major changes in the social patterning of women's health.