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<p>Increasing health inequalities among older adults globally illustrate the urgent need for effective interventions. Socio-economic position (SEP), which reflects an individual's social and economic standing, may affect healthy ageing through various life course mechanisms. However, longitudinal associations between life course SEP and healthy ageing as a multidimensional construct remain unclear. We conducted a comprehensive systematic review of longitudinal studies investigating the associations between life course SEP indicators (including education, income, occupation, wealth) and multidimensional healthy ageing outcomes. A systematic literature search was conducted across four databases (MEDLINE, Embase, PsycINFO, and Web of Science) from inception to April 2025. Due to the heterogeneity in the operationalisation of SEP and healthy ageing, a narrative synthesis was performed (Prospero CRD42023418728). 47 articles were included in the review. Across multiple SEP indicators and life stages, higher educational levels (39/43 studies) and higher income/wealth (31/36 studies) were positively associated with better healthy ageing outcomes. Occupation showed inconsistent evidence. Life-course evidence showed childhood SEP disadvantage predicted poorer later-life outcomes (13/17 studies), with cumulative multi-stage disadvantage showing additive effects (5 studies) and upward mobility conferring benefits (3 studies). These patterns manifested in three age-related inequality trajectories: widening (18/23 studies), convergence, and persistence, with education-cognitive disparities showing strongest widening effects. Cross-national evidence revealed regional specificities. Studies also identified sex/gender moderation effects (5 studies) and examined mediating pathways (6 studies). Higher education showed the most consistent protective effects, while income/wealth effects were complex. Health inequalities widened with age, highlighting lasting childhood impacts. Targeted interventions addressing early educational investment and life stage-specific strategies are needed for reducing healthy ageing inequalities.</p>

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Socio-economic position and healthy ageing across the life course: a systematic review of longitudinal studies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月6日

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  • Yisheng Ye,
  • Chengxu Long,
  • Kia-Chong Chua,
  • Darío Moreno-Agostino,
  • Matthew Prina

摘要

Increasing health inequalities among older adults globally illustrate the urgent need for effective interventions. Socio-economic position (SEP), which reflects an individual's social and economic standing, may affect healthy ageing through various life course mechanisms. However, longitudinal associations between life course SEP and healthy ageing as a multidimensional construct remain unclear. We conducted a comprehensive systematic review of longitudinal studies investigating the associations between life course SEP indicators (including education, income, occupation, wealth) and multidimensional healthy ageing outcomes. A systematic literature search was conducted across four databases (MEDLINE, Embase, PsycINFO, and Web of Science) from inception to April 2025. Due to the heterogeneity in the operationalisation of SEP and healthy ageing, a narrative synthesis was performed (Prospero CRD42023418728). 47 articles were included in the review. Across multiple SEP indicators and life stages, higher educational levels (39/43 studies) and higher income/wealth (31/36 studies) were positively associated with better healthy ageing outcomes. Occupation showed inconsistent evidence. Life-course evidence showed childhood SEP disadvantage predicted poorer later-life outcomes (13/17 studies), with cumulative multi-stage disadvantage showing additive effects (5 studies) and upward mobility conferring benefits (3 studies). These patterns manifested in three age-related inequality trajectories: widening (18/23 studies), convergence, and persistence, with education-cognitive disparities showing strongest widening effects. Cross-national evidence revealed regional specificities. Studies also identified sex/gender moderation effects (5 studies) and examined mediating pathways (6 studies). Higher education showed the most consistent protective effects, while income/wealth effects were complex. Health inequalities widened with age, highlighting lasting childhood impacts. Targeted interventions addressing early educational investment and life stage-specific strategies are needed for reducing healthy ageing inequalities.