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Title: Socioeconomic inequality in recovery from poor physical and mental health in mid-life and early old age: prospective Whitehall II cohort study.
Authors: Tanaka, A
Shipley, MJ
Welch, CA
Groce, NE
Marmot, MG
Kivimaki, M
Singh-Manoux, A
Brunner, EJ
First Published: 8-Feb-2018
Publisher: BMJ Publishing Group
Citation: Journal of Epidemiology and Community Health, 2018;72:309-313.
Abstract: BACKGROUND: Few studies have examined the influence of socioeconomic status on recovery from poor physical and mental health. METHODS: Prospective study with four consecutive periods of follow-up (1991-2011) of 7564 civil servants (2228 women) recruited while working in London. Health was measured by the Short-Form 36 questionnaire physical and mental component scores assessed at beginning and end of each of four rounds. Poor health was defined by a score in the lowest 20% of the age-sex-specific distribution. Recovery was defined as changing from a low score at the beginning to a normal score at the end of the round. The analysis took account of retirement status, health behaviours, body mass index and prevalent chronic disease. RESULTS: Of 24 001 person-observations in the age range 39-83, a total of 8105 identified poor physical or mental health. Lower grade of employment was strongly associated with slower recovery from poor physical health (OR 0.73 (95% CI 0.59 to 0.91); trend P=0.002) in age, sex and ethnicity-adjusted analyses. The association was halved after further adjustment for health behaviours, adiposity, systolic blood pressure (SBP) and serum cholesterol (OR 0.85 (0.68 to 1.07)). In contrast, slower recovery from poor mental health was associated robustly with low employment grade even after multiple adjustment (OR 0.74 (0.59 to 0.93); trend P=0.02). CONCLUSIONS: Socioeconomic inequalities in recovery from poor physical health were explained to a considerable extent by health behaviours, adiposity, SBP and serum cholesterol. These risk factors explained only part of the gradient in recovery for poor mental health.
DOI Link: 10.1136/jech-2017-209584
eISSN: 1470-2738
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Description: Whitehall II data, protocols and other metadata are available to bona fide researchers for research purposes. Please refer to the Whitehall II data sharing policy at
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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