A life course perspective on socioeconomic inequalities in health: A critical review of conceptual frameworks

Social scientists and public health researchers have long known that social position is related to health and that socioeconomic inequalities in health persist in later life. Increasingly, a life course perspective is adopted to understand the socioeconomic position (SEP)-health dynamic. This paper critically reviews the conceptual perspectives underlying empirical research seeking to better understand socioeconomic inequalities in health in the context of the life course. I comment on the contributions of this work, but also its limitations. In particular, I note the emphasis on understanding the mechanisms linking SEP to health, to the exclusion of research on the institutional and structural factors associated with socioeconomic inequalities over the life course. I also critique the relative absence of gender in this work, and how, by not linking individual experiences to the social policy contexts that shape resources and opportunities, the proximal, rather than the structural or institutional determinants of health are emphasized. I suggest that moving forward, a return to some of the key tenets of life course theory, including contributions from the comparative welfare states literature, may better inform life course analyses of socioeconomic inequalities in health. Specific suggestions for life scholarship are discussed.