Effects of income and wealth on GHQ depression and poor self rated health in white collar women and men in the Whitehall II study.

STUDY OBJECTIVE To determine whether measures of income and wealth are associated with poor self rated health and GHQ depression. DESIGN Whitehall II study of London based civil servants re-interviewed between 1997-1999; 7162 participants. MAIN RESULTS A twofold age adjusted difference in morbidity was observed between the top and bottom of the personal income hierarchy for both sexes. For household income and particularly for wealth these associations are stronger. After adjusting for health at baseline the associations between personal income and both health outcomes are reduced by about 40%-60%. For household income the attenuation is somewhat smaller and for wealth is about 30%. Adjusting for other sociodemographic factors leads to further attenuation of the effects. CONCLUSIONS The associations between income, particularly personal income, and morbidity can be largely accounted for by pre-existing health and other measures of social position. The strong independent association between household wealth-a measure of income earned over decades and across generations-and morbidity are likely to be related to a set of early and current material and psychosocial benefits.