The Long Reach of Childhood Health and Circumstance: Evidence from the Whitehall II Study

We use data from the Whitehall II Study to examine the joint evolution of health status and economic status over the life course. We study the links between health and socioeconomic status in childhood and health and employment status in middle and older ages. Because the population from which this cohort was drawn consisted almost exclusively of white collar civil servants, the Whitehall II sample will in general provide inconsistent estimates of the association between childhood conditions and adult outcomes for the population as a whole. To sign the direction of the bias, we compare our findings for Whitehall II with those from two nationally representative data sets in which we can mimic selection into white collar positions. We find that the Whitehall II estimates are systematically lower than those from our nationally representative cohorts, until we restrict those cohorts to their white collar members only. In contrast to researchers who have used the Whitehall II data to argue against parental disadvantage as an explanation of socioeconomic inequality in health, we find early life socioeconomic status is significantly associated with health over the life course. Using fixed effect first-difference models, we examine the association between health and employment status in middle age and health and employment status at older ages. We find that current position in the civil service is not associated with future health, but current self-assessed health is significantly associated with promotion in the civil service.