Lifelong socio-economic position and later life health related behaviour: A causal mediation approach

Population ageing is one of the dominant trends of the 21st century. Considering that morbidity is concentrated in the older population interventions to promote healthy ageing and healthy life expectancy are needed in order to offset the effects that ageing will have on population health. Health related behaviour use is a focal area for possible interventions since its association with various health outcomes is well documented. We used data from the English Longitudinal Study of Ageing with a formal approach for the identification of mediating factors in order to investigate the lifecourse socio-economic patterning of smoking, physical activity, dietary habits and alcohol use in later life. We observed socio-economic gradients in smoking, physical activity and alcohol use, but to a lesser extend in healthy dietary habits. Both early and later life socio-economic circumstances influenced health related behaviour, but these associations differed between men and women as well as between age groups. We found that early life circumstances influence behaviour either directly or indirectly 65 years after and their effect reaches until early old age. The complexity of the observed associations highlights the need for further research on the mechanism that underlies the links between SEP and later life health related behaviour.