Inequalities in adult physical capability

Women are disproportionally more likely than men to develop disabilities in older age, with longitudinal evidence showing that these differences emerge earlier in life.

A study[1] including more than 3,000 members of the Medical Research Council National Survey of Health and Development (1946 British birth cohort) compared men and women’s self-reported difficulty with day-to-day physical tasks, including walking and climbing stairs at ages 43 and 53.

At age 43, around 5 per cent of women reported that they had problems walking and using stairs due to a long-term health problem. A similar number reported having trouble gripping lids or reaching with their arms. Just over 3 per cent of men reported similar problems.

Ten years later, the gap between men and women had increased dramatically. Over 28 per cent of women reported difficulty performing simple tasks with their hands and arms, compared to just 12 per cent of men. Around one in five women reported difficulty with routine activities such as walking and stair climbing, compared to around one in ten men.

The social inequalities we experience in early life matter to our physical capability in middle age, but the nature of this relationship can vary across measures.

Analyses of more than 2,900 members of the Medical Research Council National Survey of Health and Development[1]^,[2],[3] (1946 British birth cohort) found that different measures of socioeconomic position were associated with different measures of physical capability . For example, cohort members whose mothers had little or no education had poorer standing balance at age 53 than those whose mothers were highly educated.

On the other hand, it was their fathers’ occupations that were associated with their ability to get up and down from a chair – those whose fathers were in non-manual job were able to do this more easily than those whose fathers were manual workers.

The researchers found no association between childhood socioeconomic position and grip strength at this age.

In another set of analyses using the 1946 British birth cohort[4], researchers grouped the physical capability measures to create an overall score. They found that having a father in a manual job was associated with lower overall performance and having a well-educated mother was associated with better overall performance.

In both studies, the associations remained even after controlling for a range of factors in both childhood and adulthood, including the cohort members’ own education, occupation and lifestyles.

Subsequent findings from the 1946 British birth cohort[5] have shown that existing socioeconomic inequalities in physical

Findings from Whitehall II[1], a longitudinal study of civil servants, show that self-reported physical functioning deteriorates more rapidly among those from lower employment grades.

Researchers analysed information on the general health and physical problems of more than 10,000 civil servants, which they compared to the individuals’ employment grade.

People in low-grade posts aged more quickly than their peers in more senior positions. For example, the average physical health of a 45-year-old man in a high-grade post was equivalent to that of a man four and half years younger who had worked in a low-grade job.

By age 70, the average health of a man in a high-grade post was similar to that of a low grade man eight years younger. The differences were similar for women.

Material deprivation can also help identify those at greater risk of physical decline.

Researchers analysed information on more than 3,200 men and women aged 59 to 73 of the Hertfordshire Cohort Study[2]. They compared different measures of the cohort members’ physical