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

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.

Lack of association between drought and mental health in a cohort of 45–61 year old rural Australian women

“…32 Furthermore, it is responsive to change over time. [33][34][35] The Mental Health Index contains five items measuring: nervousness; low mood; feeling down; feeling calm and peaceful; and being happy. Scores range from 0 to 100, with higher scores indicating better mental health.…”

What Money Can (and Can't) Buy: A Behavior Genetic Analysis of the Physical and Mental Health Benefits of Socioeconomic Advantage in Modern America

“…Socioeconomic factors (particularly parental education) are also implicated in externalizing problems in adolescents (Amone-P' Olak et al, 2009;Bøe et al, 2012;Huisman et al, 2010), including aggression (Amone-P'Olak et al, 2009), delinquency or misconduct (Amone-P' Olak et al, 2009;Bøe et al, 2012), and symptoms of attention-deficit/hyperactivity disorder (Amone-P' Olak et al, 2009;Bøe et al, 2012; National Center for Health Statistics, 2012). There is also evidence that lower SES impedes the gradual increase in mental health that occurs during mid-to later adulthood (Williams, Cunich, & Byles, 2013).…”

“…In a natural experiment of the SES-health gradient, one study showed that individuals coming from U.S. states that had compulsory school laws show better self-rated health, less cardiovascular disease, fewer weight problems, and lower mortality rates (Fletcher, 2015;Lleras-Muney, 2005). Lower SES also hastens the gradual decline in health that begins in middle adulthood (Williams, Cunich, & Byles, 2013).…”

“…First, this relation is broad and spans many aspects of physical health, including self-rated health (Goodman, 1999;Eibner & Evans, 2005); various acute and chronic health conditions (Almqvist et al, 2005;Basagaña et al, 2004;Bengtsson et al, 2005;Cesaroni et al, 2003;Clark et al, 2009;Connolly et al, 2000;Cunningham & Kelsey, 1984;Diez-Roux et al, 1997;Evans et al, 2000;Haynes et al, 2006;Lee et al, 2011;Rabi et al, 2006;Stringhini et al, 2013;Sundquist et al, 2004); body mass index, adiposity, and obesity (Eibner & Evans, 2005;Stafford & Marmot, 2003); immune functioning (Alley et al, 2006;Chen et al, 2006;Dowd & Aiello, 2009;Deverts, Cohen, Kalra, & Matthews, 2012;Dowd et al, 2008); and mortality (Adler et al, 1994;Adler & Ostrove, 1999;Eibner & Evans, 2005;Goodman et al, 2003;Singh, 2003). Second, SES hastens the gradual decline in health that begins in middle adulthood (Williams et al, 2013). Third, existing behavior genetics research on the SES-physical health gradient demonstrates that this relation is far more nuanced than correlational or natural experimental studies suggest.…”

“…Unfortunately, these also happen to be the SES indicators that may be most appropriate for inferring causality in the SES-health gradient. Lifespan research suggests that the effects of low SES on health accumulate over time (Fone et al, 2013;Karriker-Jaffe et al, 2013;Ross & Wu, 1996;Miech & Shanahan, 2000;Prus, 2007;Singh-Manoux, Ferrie, Chandola, Marmot, 2004;van de Mheen, Stronks, & Mackenbach, 1998;Williams et al, 2013;Yen & Kaplan, 1998) and have their debut in childhood (Singh-Manoux et al, 2004;van de Mheen et al, 1998). Future research may explore opportunities for conducting natural experiments on the SES-health gradient, comparing, for example, SES effects on health in children and adolescents in capitalist versus socialist nations; countries with high income inequality versus those with low inequality; or societies with inexpensive or nocost post-secondary educational opportunities versus those with costly ones.…”