The roles of non-cognitive and cognitive skills in the life course development of adult health inequalities

Abstract

Previous research has suggested that greater cognitive skill is protective against the development of socioeconomic health inequalities across the life course, but the relative role of non-cognitive skills has been less investigated in this context. Using the prospective UK 1958 National Child Development Study (N = 18,558), higher factor scores for adolescent non-cognitive skills (NCS; i.e. a combination of work habits and pro-social behaviours) and mean cognitive skill (CS) at age 16 were examined with a path analysis model in relation to socioeconomic status (SES) across the life course (at ages 16, 33 and 50) and poor self-reported health at age 50. Adjusting for adolescent NCS explained over a third of the association between education and health, but the path between social class at age 50 and health was unaffected. Adjustment for CS explained larger proportions of the paths to adult health inequalities; and paths between CS and SES across the life course were stronger than the same paths with NCS. However, NCS was still independently associated with paths to later health inequalities in fully adjusted models, and both types of skill had equivalent inverse direct effects with poor health (OR: 0.82 [95% CI 0.73,0.93] vs 0.83 [0.72,0.96], respectively). Since NCS retained independent associations with SES and health across the life course, they could be a target for policies aimed at ameliorating the production of health inequalities for a wide range of children, regardless of their cognitive skill.