Socioeconomic influences at different life stages on health in Guangzhou, China.

ABSTRACT

In long-term developed countries socioeconomic position across the life course is positively associated with health. We examined these associations in a developing country with a history of efforts to reorganize the social hierarchy. Taking a life course perspective, we used multi-variable logistic regression to assess the association of socioeconomic disadvantage at four life stages (measured by parental possessions, education, longest-held occupation and current household income) with self-rated health, chronic obstructive pulmonary disease (COPD) and metabolic syndrome in 20,086 Chinese adults aged ≥50 years from the Guangzhou Biobank Cohort Study (2005-2008). Model comparisons were used to determine whether the number of exposures to disadvantage (accumulation of risk) was more important than the life stage of exposure (critical periods). Socioeconomic disadvantage across the life course was associated with poor self-rated health, COPD and, in women only, with metabolic syndrome. Adjusting for adult health-related behavior (smoking, alcohol use and physical exercise) altered these associations very little. Associations between socioeconomic disadvantage and health in this Southern Chinese population were broadly similar to those found in Western countries in terms of the accumulation of disadvantage across the life course. However, longest-held occupation was not independently associated with adult health and socioeconomic disadvantage was not associated with metabolic syndrome in men. This suggests that the mechanisms linking socioeconomic position to health in China may be different from those in Western populations and may require context-specific policy interventions.