Class inequalities in women's health: combined impact of childhood and adult social class - a study of 630 US women

To assess contributions of childhood and adult social class to class gradients in women's health, the authors used gender-neutral household measures of class position in a retrospective cohort study of 630 women enrolled in Examination II of the Kaiser Permanente Women Twins Study (1989-1990, Oakland, CA). The age-adjusted odds of reporting fair or poor health was 2.3 times higher (95% confidence interval (CI)=1.2-4.1), using adult class measures, among women categorized as working class vs non-working class/professional. When stratified by childhood social class, however, the elevated risk of fair/poor health among adult working class compared to non-working class/professional women was evident only among those with a non-working class/professional childhood. Similarly, a working class tendency (based on adult class position) towards elevated levels of low density lipoprotein (LDL) cholesterol (odds ratio (OR)= 1.5, 95% CI = 0.9-2.7) and post-load glucose (OR = 1.8, 95% CI= 1.0-3.3) was apparent only among women who were non working class in childhood. These results indicate that both childhood and adult class position influence class gradients in women's health in the United States.