Why are middle class older people so much more healthier than their poorer counterparts?

[Gorzf]

Sorry, if this is obvious to people but I can't help but notice all the well off people I meet in their 50s/ 60s / 70s, they're just healthy, their skin is glowing, they're fit and mobile.

I am a child of immigrants who came with nothing. We were quite poor growing up, the only kid in my friendship group on free school meals. Even as an adult I'm not particularly well off, just getting by. Growing up, most older people in my poor area / community just declined. It was almost a thing I thought was just normal, that's what happens.

It wasn't as I grew older and started meeting people from different socioeconomic status that I realised that wasn't the case.

It can't just be about having more money, surely. What is it that they're doing that the poor folk around me didn't do.

This.. I've been in both worlds and it's this and what everyone else has said. Older people who exercise, eat well, don't drink or smoke, have less worries look completely different to the ones who have done the opposite.

When I eat rubbish I start looking and feeling bad after only a couple of weeks. Add smoking and drinking to that and do that for decades

I think a lot of it is diet and exercise. My family is large and half very working class, half middle class, and my partner is from a wealthy background and I can see the disparity.

Even across the generations you see a difference. My Nans family was very very poor, but cooked from scratch from their vegetable gardens and lived rurally and actively- most lived in good health to late 80's and 90's.

My working class family now eat lots of processed foods, a lot of takeaways like dominos and McDonald's, and rarely any veg or fresh foods. They consider half a mile too far to walk, and don't exercise. Holidays and leisure are drinking focused, they like going to all inclusives or places with strips of bars and English restaurants. Young children eat crisps and biscuits for breakfast before school, chocolate throughout the day, frozen food for dinner. They have TVs in their bedrooms and video games, and spend a lot of the weekends inside. Most of my working class family are overweight/obese.

My middle class family and my partners wealthier family eat lots of fruit and veg, salads for lunch, cook from scratch, lots of dog walks, jogging, swimming daily. Chocolate or crisps are rare treats for the children. Holidays are exploring and walking with the children. Children think nothing of walking to school, or walking a couple of miles with the dogs before school, and they do lots of sporting activities. They're mostly slim and toned.

I grew up eating a bad junk food diet and didn't look very healthy as a child. After university, I was working and living with a lot of better off people in London and I started eating better and cooking healthy food from scratch also like them. Although my friends definitely drink and take drugs recreationally, they're very diet focused and and exercise/walk daily and they're slim and healthy looking. Their children are also, lots of walking, bike rides, healthy food, national trust memberships, museum trips, time outside of the house etc.

Social Health Gradient is real caused by social structures. As mentioned above Tudor Hart but also Marmot (UCL). He wrote papers advising government how to tackle the social determinants of health. They have not.
That said, obviously always exceptions, my parents grew up absolutely dirt poor and are in good health. In-laws v privileged and total self neglect. But it was getting wealthier that allowed my parents to turn it around.
”Lifestyle choices” are only really choices for the wrll off (money but also time/social network/ intelligence)

There is a road close to where I live. It starts in a nice MC town and ends up in the centre of a deprived town.

House prices go down as you move from one end of the street to the other.
Poverty increases.
People lose 15 years! In life span from one end to the other.

Its shocking 😢😢
You can’t even say it’s access to better healthcare because until recently, few people would go private there, incl,the MC ones.

I live in a well off part of London. The women and men look so healthy here honestly. It's an entire lifestyle. At the weekends they will be doing exercise with kids, they eat nutritious health food. It's so so different from where I am from in a working class northern town.

For older women, I think some of it is hair. When you're young, hair often looks nice long and loose. As you age, you often need to be a bit more groomed. Wealthier women tend to go to the hairdresser's a lot more. I know older women who go once a week to have their hair blow dried. They can also pay to colour their hair...even if it's grey, it's a nice grey. In a poorer part of town, I've noticed a lot of the older women still have long hair rather than a style...it's often lank and greying and tied up. I think it makes a huge difference to the overall look.

It’s been a long time since I’ve read his research & worked on this sort of thing, so I don’t feel informed enough to answer that.

What do you class as 'middle class' OP ?

It’s been a long time since I’ve read his research & worked on this sort of thing, so I don’t feel informed enough to answer your question. Let’s hope so though :)

Physical jobs vs being penpushers.

Yes, this.

There's a photo of my very well groomed Aunt and MIL (who is actually 8 years younger than my Aunt) and they barely look like they're even the same species. My Aunt looks like my MIL's much younger sister.

Poverty kills.

my mum and dad died 10 years sooner than they would have done if they had been middle class.

it’s a combination of all the little things. More money, better food, more time, better house, less worry etc etc.

this is why reducing poverty literally saves lives. Imagine if we got rid of poverty world wide ?

Better, dryer housing
Better healthcare (don’t mean private: middle classes tend to expect and demand more)
Better diets
Less likely to smoke
More time to exercise/care for themselves
More holidays/leisure time
Less constant stress about small stuff

Better food and exercise

I remember as a secondary school teacher taking my bottom set year 7 students down to an event will with the whole of year 7 and realising how much shorter the majority my class was. The shorter students were all some the same area and FSM students. I obviously knew about the difference but this was such a stark and obvious contrast.

What resulted in your family ending up half poor vs MC? I guess education/access to university played a role, but what else? What might have lifted the 'poor side' of your family out of poverty?

I'm not sure I agree. These days it seems that sedentary jobs are considered much worse for health than active jobs. Though of course a person who uses a phrase like pen pusher years after pens have no longer been pushed might not agree😉

Poor nutrition is definitely an issue.
There are lots of people who think cooking is putting frozen food in the oven or boiling pasta and hotdogs. They can't imagine cooking what the majority of the world would consider cooking.
They're under the impression that it's difficult and isn't as tasty as food like chips and pizza.
My own dcs, who have been raised mainly on home cooked food, would choose pizza and chips over most other food because it tastes amazing to them.
The amount of research and factory chemicals that go into making cheap crap food delicious is vast so it's not surprising.
I feel so crap after a day or two of eating badly that I dread to think what a lifetime of that would do to me.

Couple with not moving much will bring in the health issues.

So much research now shows that movement contributes hugely to better health. Not just physically but mentally as well.

@PaminaMozart I think maybe outlook? It's hard to say. My mums family are working class, some manual jobs, trades, 16 hours and benefits for single parents. My dads family are all middle class, although came as immigrants without much and in a single parent household. They value education, took degrees at night school whilst working, are senior managers or business owners. They like experiences and travel and have pushed education on their children. Who have all done well - lawyers, accountants, business owners etc. My dad was very education and extra curricular focused and I'm very grateful to him.

I think there have been multiple opportunities and exposure for my working class family. But they like things as they are. We're sometimes teasingly laughed at for what we eat, for the educational activities, for the types of holidays (hiking or museums etc boring, skiing wanky etc). Children aren't made to do homework and spend a lot of time on devices and with screens.

It's not intrinsically about money, it just looks like it because we live in societies where the basics of a healthy life (access to good food, enough physical activity, health and dental care) are often out of reach for people on low incomes. Society doesn't need to be that way.

There's been some interesting work on the blue zones where people live longest, and not everyone there is rich. Some of the blue zone features (like good shops and green space in walking distance for even the poorest homes) could be done anywhere.

Early evidence from making changes inspired by blue zones does suggest that having an environment that makes healthy choices easier does improve outcomes. Theres a snowball effect too - the more you're around people who make healthy choices the more likely you are to be able to do that yourself.

This reminds me of when our DD was in Year 7 at her independent school. She was in the netball team and they went to play against a local academy school in a deprived area. Our DD's team were all considerably taller and far more athletic. in build. They weren't nearly as winded as the other team at the end of the game either. Afterward, DD's team snacked on fresh fruit, water, and home made sandwiches. The other team snacked on crisps, fizzy drinks and sweets.

I was born in the early 1960s and there have been huge changes in my lifetime which probably interact with each other to make things worse. Semi-skilled and unskilled jobs are now really thin on the ground. For those who left school with no or few qualifications and poor literacy, numeracy and communication and social skills, there's not much chance of getting a job, and certainly not a full-time, permanent pensionable job for life. On the one hand, this means some occupational diseases will be less common, but the effects on mental health must be catastrophic. People need structure to their lives, and they need purpose. This has to be one reason why lower income groups haven't given up smoking at anything like the rate of wealthier people, why there's such a problem with crime, drink and drugs on 'problem' estates, why there's more violence, obesity and all the other things associated with low life expectancy.

They eat better, exercise more, live in better housing and get help quicker for their conditions. Also they get better healthcare via private cover and know how to use the NHS.

Poor people get sicker. But don't overlook the fact that sick people get poorer. I'm middle class. If I lost my job through ill health and lived on benefits I'd be much poorer. If DH gave up work to care for me, we'd soon be very poor and eventually lose the house. DS would then inherit nothing. He may then not ever own a house and our middle class status is lost in one generation. Then we all get depressed and stop exercising and start eating crap. Then we lose our confidence and ability to advocate for ourselves, so we get a poor service from health professionals. And round we go.

If you’re working long hours or doing shift work, you’re unlikely going to want to come home and start cooking a healthy nutritious meal, you’re gonna reach for the convenience of a takeaway or other quick fix.
Same if your life is just shit, you’ll go for the reward of a takeaway, or other easy food. Funnily enough I don’t feel like whipping up a nice kale and quinoa salad, if I’m at a low ebb, for the all you need is a tin of tomatoes, cheese and pasta advocates.
Having prospects and a decent income makes life that bit easier and worth preserving and you’ll have the emotional energy to invest in yourself. if you’re in barely surviving mode getting yourself down the gym or doing other life enriching activities, may actually help, but having the energy to do them when your running on empty due to work or life pressures would be very difficult.