The duration and timing of exposure: effects of socioeconomic environment on adult health

Am J Public Health. 1999 Jul;89(7):1059-65. doi: 10.2105/ajph.89.7.1059.


Objectives: This study investigated timing and duration effects of socioeconomic status (SES) on self-rated health at 33 years of age and established whether health risks are modified by changing SES and whether cumulative SES operates through education.

Methods: Data were from the 1958 British birth cohort. Occupational class at birth and at 16, 23, and 33 years of age was used to generate a lifetime SES score.

Results: At 33 years of age, 12% of men and women reported poor health. SES at birth and at 16, 23, and 33 years of age was significantly associated with poor health: all ages except 16 years in men made an additional contribution to the prediction of poor health. No large differences in effect sizes emerged, suggesting that timing was not a major factor. Odds of poor health increased by 15% (men) and 18% (women) with a 1-unit increase in the lifetime SES score. Strong effects of lifetime SES persisted after adjustment for education level.

Conclusions: SES from birth to 33 years of age had a cumulative effect on poor health in early adulthood. This highlights the importance of duration of exposure to socioeconomic conditions for adult health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Educational Status
  • Female
  • Health Status*
  • Humans
  • Logistic Models
  • Male
  • Risk Factors
  • Socioeconomic Factors*
  • Time Factors
  • United Kingdom / epidemiology