Evidence from the 2001 English Census on the contribution of employment status to the social gradient in self-rated health

Background Unemployment and economic inactivity are associated with poor health. There are social gradients in unemployment and economic inactivity, so it was hypothesised that they may contribute to the social gradient in self-rated health.

Methods Data on employment status, socio-economic position (SEP) and self-rated heath were obtained for people of working age (25-59) who had ever worked from a 3% sample of the 2001 English census. The age-adjusted prevalence differences in poor general health for four separate measures of SEP were compared with the prevalence differences obtained after additional adjustment for employment status.

Results Prevalence differences for poor health were reduced by 50% or over when adjusting for employment status (for men ranging from 57% to 81%, for women 50% to 74%).

Discussion The social gradient in employment status contributes greatly to the social gradient in self-reported health. Understanding why this is the case could be important for tackling social inequalities in health.