A Longitudinal Analysis of the Intergenerational Transmission of Health Inequality.

Objectives: Empirical investigations of cumulative dis/advantage typically treat health inequality as an intraindividual process rooted in early-life conditions and operating within the span of the individual life course, while literature on processes of intergenerational transmission has historically focused on socioeconomic mobility, largely overlooking health. The current study examines the persistence of work disability across generations and multiple explanations for this relationship, including the role of early-life disadvantage, childhood health, educational attainment, and social mobility. Methods: We model latent classes of midlife work disability characterized by timing and stability using longitudinal data from the intergenerational component of the U.S. Panel Study of Income Dynamics (N = 3,328). Latent class analysis captures the initial risk of experiencing a work disability and how this risk changes across mid-life as a function of early-life conditions, childhood health, educational attainment, mobility, and parent's work disability. Results: Early disadvantage, childhood health, and educational attainment were associated with patterns of midlife work disability, and although upward mobility provided some protection, intergenerational continuity in health remained net of all of these factors. Discussion: Findings support the importance of looking beyond the individual life course to the transmission of health inequality across generations within families.