Life course development of unequal health

Abstract

This chapter addresses the questions: Do exposures earlier in life influence the development of inequalities in adult health outcomes? How much of the adult socio-economic gradient is explained by factors occurring earlier on? In addressing these questions the chapter first identifies factors from early and later life stages that are implicated in the development of adult disease and shows that many of these factors are socially patterned. It reports on the effects of the socio-economic environment in early life on adult inequalities in mortality, morbidity, and health behaviour, using a simple approach that tests whether any effects act through or independently of the adult socio-economic environment. It discusses why it is important, from a life-course perspective on the development of unequal health, to consider health and functional trajectories as well as the more conventional outcomes of morbidity and mortality. The chapter presents a conceptual framework that outlines the ways in which the early socio- economic environment can affect the development of inequalities in adult health, and then provides examples that illustrate these pathways in relation to a diverse range of adult outcomes. These include psychological distress, coronary heart disease (CHD), lung function, and physical capability.

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