The Equalisation Hypothesis
Given evidence from other research that the earlier period of childhood is characterised by health inequalities, this study examined the hypothesis of equalisation in health: specifically, that class differences in health might be reduced, removed or even reversed between childhood and adolescence. Based on the 11 to 16/16+ study, the analysis compared the social class patterning of several dimensions of health at ages 11 and 15 years.
While several health measures, e.g. longstanding illness, showed no class association at either age, evidence of equalisation was found in respect of physical symptoms for males, and malaise symptoms for females. A strong reverse gradient for malaise symptoms among females at age 15 was replicated in a separate analysis which showed middle-class females to be in the poorest mental health (GHQ). By contrast, in males class differences in accidents and injuries, particularly resulting from violence, increased between ages 11 and 15, and there was some evidence of the same in both sexes for self-rated health. Changes in the social patterning of health between childhood and youth, therefore, vary according to the dimension of health concerned, only some supporting the equalisation hypothesis. Overall, the predominant pattern is one of little or no class variation from late childhood to mid-adolescence.
West P, Sweeting H. Evidence on equalisation in health in youth from the West of Scotland. Social Science & Medicine 2004;59:13-27pubmed
West P. Health inequalities in the early years: is there equalisation in youth?. Social Science & Medicine 1997;44:833-58open access