The stability of health-related behaviour clustering during mid-adulthood and the influence of social circumstances on health-related behaviour change.

ABSTRACT

Evidence suggests that health-related behaviours (HRBs) cluster in mid-adulthood and are associated with social circumstances (i.e. economic circumstances, cultural norms, employment relations) at the same age. However, little is known about the level of stability in HRB cluster membership during mid-adulthood and how social circumstances in early mid-adulthood may influence movement between HRB clusters during mid-life. Data were taken from a British cohort born in 1958 (N = 12,784), to examine the stability of membership of three HRB clusters 'Risky', 'Moderate Smokers' and 'Mainstream' (the latter pattern consisting of more beneficial HRBs such as not smoking, moderate alcohol consumption, being physically active), between ages 33 and 42. The relationship between social circumstances at age 33 and movement between HRB clusters during mid-adulthood was also examined. HRB cluster membership was relatively stable during mid-adulthood, over 60% of the participants remained in the same cluster at both ages. However, there was considerable probability of movement from the 'Risky' and 'Moderate Smokers' clusters at age 33 to the 'Mainstream' cluster at age 42. Members of the 'Risky' cluster had a lower probability of transitioning to the 'Mainstream' cluster (men = 17%, women = 9%, p < 0.001) in comparison to the 'Moderate Smokers' cluster (men = 26%, women = 27%, p < 0.001). Social circumstances at age 33 did not influence change in HRB cluster membership between ages 33 and 42 (p > 0.05). Movement from the 'Risky' and 'Moderate Smokers' cluster to the 'Mainstream' cluster during mid-adulthood highlights improvements for most HRBs. Person-centred interventions are required to prevent persistent negative HRBs amongst 'Risky' cluster members.