Socioeconomic position, health, and possible explanations: a tale of two cohorts

Am J Public Health. 2002 Aug;92(8):1290-4. doi: 10.2105/ajph.92.8.1290.


Objectives: We examined whether the social gradient for measures of morbidity is comparable in English and French public employees and investigated risk factors that may explain this gradient.

Methods: This longitudinal study of 2 occupational cohorts-5825 London civil servants and 6818 French office-based employees-used 2 health outcomes: long spells of sickness absence during a 4-year follow-up and self-reported health.

Results: Strong social gradients in health were observed in both cohorts. Health behaviors showed different relations with socioeconomic position in the 2 samples. Psychosocial work characteristics showed strong gradients in both cohorts. Cohort-specific significant risk factors explained between 12% and 56% of the gradient in sickness absence and self-reported health.

Conclusions: Our cross-cultural comparison suggests that some common susceptibility may underlie the social gradient in health and disease, which explains why inequalities occur in cultures with different patterns of morbidity and mortality.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cohort Studies
  • Cross-Cultural Comparison
  • Employment / statistics & numerical data*
  • Female
  • France / epidemiology
  • Government Agencies
  • Humans
  • London / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Morbidity*
  • Occupational Health / statistics & numerical data*
  • Risk Factors
  • Sick Leave / statistics & numerical data*
  • Socioeconomic Factors