Socioeconomic status and heterogeneity in aging As people get older there is increasing heterogeneity in health and in physical, mental and cognitive functioning, resulting in age peers becoming more and more dissimilar from each other. Research on the determinants of this heterogeneity is crucial as positive health trajectories are related to higher quality of life, longer independence and considerably lower medical and social care costs. The Whitehall II study on 10,308 British civil servants was set up in 1985 and has played a crucial role in shaping the research agenda on social inequalities in health. Over the last 22 years participants, now aged 55-79 years, have been followed up with medical examinations at 5-year intervals and with questionnaire surveys every second or third year. Thus, Whitehall II is now primed to address one of the major challenges of the new millennium;determinants of heterogeneity in health in ageing populations. NIA support has been crucial to the addition and exploitation of functioning data in the Whitehall II study. As the participants age, this application seeks continued NIA support for further analysis of the data collected so far and to collect two more phases of data over the next 5 years. This support will enable us to address three overall aims. 1) Social inequalities in chronic diseases, mortality and functioning: To examine whether relative and absolute social inequalities in chronic diseases (coronary heart disease, stroke, diabetes) and mortality increase with age and to estimate the importance of biological, behavioral and psychosocial explanations of these inequalities. To examine the contribution of repeated measures of risk factors to contemporaneous, trajectory and accumulated risk models. To determine whether the consequences of disease on functioning differs or are moderated by socioeconomic status. 2) Cognitive changes in early old age: determinants and consequences: To examine the socioeconomic, vascular and behavioral determinants of heterogeneity in cognitive aging, starting in midlife, and to assess the consequences of cognitive decline on physical, social and mental functioning and mortality. 3) Social participation: impact on health and functioning in early old age: To examine the socioeconomic and gender patterning of social participation trajectories over the adult life course. To examine the effects of social participation on functioning and chronic disease and to address the issues of reverse causation and confounding in the association between social participation and health. The relevance of our research is tied in with continuing increase in life expectancy and the need to identify potentially modifiable risk factors to improve overall health and reduce social inequalities in the health of older populations. Aging trajectories appear to diverge fairly early on and our data on a multitude of risk factors and health measures on individuals from early mid-life to old age are an important resource to study the determinants of heterogeneity in aging trajectories.

Public Health Relevance

Whitehall II's first major achievement was to put the social gradient in health high on the research agenda of the scientific community. Testimonies to the success of that early pioneering work are replica studies in a number of countries and research programs to investigate the pathways from social position to health in every continent. Following recognition by the scientific community, the next hurdle was to bring the social gradient to the attention of policy makers. Here the effort of Professor Sir Michael Marmot has brought outstanding success culminating in Sir Michael being asked to chair the ongoing WHO Commission on the Social Determinants of Health. Now, twenty two from its inception, Whitehall II is primed to address one of the major challenges of the new millennium;disparities in health and functioning in an ageing population. Research in this domain is crucial as positive health trajectories are related to higher quality of life, longer independence and considerably lower medical and social care costs.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
Project #
Application #
Study Section
Social Sciences and Population Studies Study Section (SSPS)
Program Officer
Patmios, Georgeanne E
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University College London
United Kingdom
Zip Code
WC1 -6BT
Heise, Verena; Zsoldos, Enik?; Suri, Sana et al. (2017) Uncoupling protein 2 haplotype does not affect human brain structure and function in a sample of community-dwelling older adults. PLoS One 12:e0181392
Wagner, Róbert; Tabák, Ádám G; Fehlert, Ellen et al. (2017) Excessive fuel availability amplifies the FTO-mediated obesity risk: results from the TUEF and Whitehall II studies. Sci Rep 7:15486
Virtanen, Marianna; Elovainio, Marko; Josefsson, Kim et al. (2017) Coronary heart disease and risk factors as predictors of trajectories of psychological distress from midlife to old age. Heart 103:659-665
Bell, J A; Sabia, S; Singh-Manoux, A et al. (2017) Healthy obesity and risk of accelerated functional decline and disability. Int J Obes (Lond) 41:866-872
Færch, Kristine; Witte, Daniel Rinse; Brunner, Eric John et al. (2017) Physical Activity and Improvement of Glycemia in Prediabetes by Different Diagnostic Criteria. J Clin Endocrinol Metab 102:3712-3721
Hansen, Christian Stevns; Vistisen, Dorte; Jørgensen, Marit Eika et al. (2017) Adiponectin, biomarkers of inflammation and changes in cardiac autonomic function: Whitehall II study. Cardiovasc Diabetol 16:153
Menai, Mehdi; van Hees, Vincent T; Elbaz, Alexis et al. (2017) Accelerometer assessed moderate-to-vigorous physical activity and successful ageing: results from the Whitehall II study. Sci Rep 8:45772
Brunner, Eric John (2017) Social factors and cardiovascular morbidity. Neurosci Biobehav Rev 74:260-268
Borges, Maria Carolina; Barros, Aluísio J D; Ferreira, Diana L Santos et al. (2017) Metabolic Profiling of Adiponectin Levels in Adults: Mendelian Randomization Analysis. Circ Cardiovasc Genet 10:
Landy, Rebecca; Head, Jenny; Richards, Marcus et al. (2017) The effect of life course socioeconomic position on crystallised cognitive ability in two large UK cohort studies: a structured modelling approach. BMJ Open 7:e014461

Showing the most recent 10 out of 538 publications