The impact of socioeconomic status on changes in the general and mental health of women over time: evidence from a longitudinal study of Australian women.

Jennifer Stewart Williams,Julie Byles,Michelle Cunich

doi:10.1186/1475-9276-12-25

Abstract

IntroductionGenerally, men and women of higher socioeconomic status (SES) have better health. Little is known about how socioeconomic factors are associated with changes in health as women progress through mid-life. This study uses data from six survey waves (1996 to 2010) of the Australian Longitudinal Study on Women’s Health (ALSWH) to examine associations between SES and changes in the general health and mental health of a cohort of women progressing in years from 45–50 to 59–64.MethodsParticipants were 12,709 women (born 1946–51) in the ALSWH. Outcome measures were the general health and mental health subscales of the Medical Outcomes Study Short Form 36 Questionnaire (SF-36). The measure of SES was derived from factor analysis of responses to questions in the ALSWH baseline survey (1996) on school leaving age, highest qualifications, and current or last occupation.Multi-level random coefficient models, adjusted for socio-demographic factors and health behaviors, were used to analyze repeated measures of general health and mental health. Survey year accounted for changes in factors across time. In the first set of analyses we investigated associations between the SES index, used as a “continuous” variable, and general health and mental health changes over time. To illuminate the impact of different levels of SES on health, a second analysis was conducted in which SES scores were grouped into three approximately equal sized categories or “tertiles” as reported in an earlier ALSWH study. The least square means of general and mental health scores from the longitudinal models were plotted for the three SES tertiles.ResultsThe longitudinal analysis showed that, after adjusting for the effects of time and possible confounders, the general (mental) health of this cohort of mid-aged women declined (increased) over time. Higher SES women reported better health than lower SES women, and SES significantly modified the effects of time on both general and mental health in favor of higher SES women.ConclusionsThis study contributes to our current understanding of how socioeconomic and demographic factors, health behaviors and time impact on changes in the general and mental health of women progressing in years from 45–50 to 59–64.

Highlights

Men and women of higher socioeconomic status (SES) have better health
38.9% were in the low SES tertile, 35.6% were in the mid SES tertile and 25.5% were in the high SES tertile
Compared with low and mid SES groups, a greater proportion of high SES women were living in urban areas (78.0% vs. 69.1% vs. 71.8%); separated, divorced, widowed or single (21.8% vs. 16.6% vs. 18.9%); non-smokers (58.5% vs. 51.4% vs. 51.3%); had normal body weight (59.7% vs. 49.3% vs. 52.9%), and found it easy to manage on their incomes (22.8% vs. 12.6% vs. 14.6%)

Summary

Introduction

Men and women of higher socioeconomic status (SES) have better health. Little is known about how socioeconomic factors are associated with changes in health as women progress through mid-life. People of higher socioeconomic status (SES) have better health indicators [1]. Changes in health occur with advancing age This is attributable to biology and to social and economic factors. Both in absolute and relative terms, people are living longer but they are spending more years in declining health [4]. The ageing of our populations and socioeconomic inequalities in health present major challenges for many areas of policy [5,6]

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Results

Discussion

Conclusion