Health, social roles and the life course : a study of Australian women born between 1926 and 1966

Abstract

This study investigated the relationships between Aush-alian women's social-role and health careers. Most previous studies have used current-status measures of role participation. It is a premise of this stiidy that these current-statiis indicators are unsatisfactory because they poorly reflect social-role careers. As an alternative, this study adopted a life-course approach where early-adulthood social-role structures are thought to govern \he rest of the life course by conditioning the types of experience that people are likely to encounter, suggesting that there is a sti-ong emphasis on widespread patterns of maintenance and equilibrium that continuously convert circumstances from early to later life-course phases. The analysis primarily used Australian Family Project (AFP) data collected in 1986-87 combined with follow-up data gathered in 1990 from women who were living in Sydney at the time of the first survey (n=291). Where possible a supporting analysis was carried out using AFP data for metropolitan Australia (n=1678). Respondents were aged between 20 and 59 years at the baseline. The health indicators of the study include histories of self-reported serious chronic disease, psychological distress (GHQ) and self-rated health. Social-role careers were reconstructed from recalled event-history data starting at exact age 20 years. The main results indicate that early-adulthood social-role careers are significantly related to subsequent social and health statuses. Regardless of cohort, women who experienced varied role combinations between the ages 20 and 29 years, in particular those spending most of this time not employed, tended to have a lower risk of chronic disease over the subsequent course of their lives than women who followed more uniform careers, especially those who spent most of their 20s employed while rearing children. Variability in women's social careers after age 30 years had little effect on chronic disease risk for the majority of early-adulthood groups, although women who delayed marriage and a 'traditional' career (not employed, married with children) until late in early adulthood substantially increased their risk of disease. In relation to psychological distress and self-rated health, women bom between 1946 and 1956 who followed a traditional career during most of their 20s tended to have higher levels of psychological distress and to rate their health worse at the time of the Follow-up Survey than their non-traditional counterparts. On the other hand, older women who spent most of their 20s in a traditional career tended to have the best mental health, while those who had three or more children rated their health the best. It was also found that chronic disease significantly affects role participation. Respondents who developed a long-standing chronic condition early in life were more likely to have had fewer children, and to have been separated, divorced or widowed With regard to employment, the effects are more complex: for older women (born 1926-46), the influence of chronic disease changes over the life course. At young ages those with a childhood chronic disease were more likely to have been continually employed while 'healthy' women were selected out of the work force to start a family. In contrast, middle age saw those with chronic disease more likely either to remain out of the labour force or leave it. The younger cohort (bom 1946-66) showed a 'healthy worker' effect much earlier than the older cohort: those who had a chronic disease were more likely to have remained out of the work force or experienced multiple employment-status transitions. In conclusion, the present study has offered an innovative approach to examining the relationships between social-role and health careers. The findings have provided support for the notion that early-adulthood social-role careers for women are important determinants of their subsequent health status; and that social selection occurs at most stages of the life course and is probably influenced by social and economic changes. Such findings have far-reaching implications in terms of government policies, suggesting that governments look beyond the socio-economically disadvantaged to broader indicators of women's social careers. In relation to research, advancing technology, and larger and more comprehensive longitudinal data sets will enable other life-course studies to bring us closer to understanding why and how social forces are associated with the health status of people. Show more