Accumulated occupational class and self-rated health. Can information on previous experience of class further our understanding of the social gradient in health?

Previous research has shown a social gradient in health with better health for people in more advantaged positions in society. This research has mainly been on the relationship between current position and health, or social position in childhood and health, but less is known about the potential accumulative impact of positions held in adulthood. In this paper I use the economic activity histories from the Swedish Level of Living survey to examine the relationship between accumulated occupational class positions and health. Step-wise linear probability models are used to investigate how to best capture the potential association between class experience and self-rated health (SRH), and whether the effect of current class is modified when measures of accumulated class are included. I then further test the potentially lasting association between previous exposure to the health risk of working class by analysing only individuals currently in higher or intermediate level service class; the classes under least exposure.I find a positive association between accumulated experiences of working class and less than good SRH. Furthermore, even for employees currently in non-manual positions the risk for less than good SRH increases with each added year of previous experience within working class. This suggests that the social gradient can be both accumulative and lasting, and that more information on the mechanisms of health disparities can be found by taking detailed information on peoples' pasts into account. Although gender differences in health are not a focus in this paper, results also indicate that the influence of class experiences on health might differ between men and women.

► Finds an increased risk for less than good self-rated health per each year of previous working class experience.
► The risk still remains in separate analysis on individuals currently in service-class positions.
► Indicates that the effects of the social gradient can be accumulated during working life, and can be lasting.
► Highlights the utility of examining not only class experiences, but also the duration of these experiences.