These binary measures were then summed to create the overall allostatic load score (ranging from 0 to 9) (Seeman et al., selleck kinase inhibitor 2004 and Bird et al., 2010). SEP was based on head of household occupational social class (Registrar General’s 1980 Social Class (RGSC) OPCS, 1980) and operationalized as the accumulated SEP over two time periods spanning 20 years. SEP was measured at baseline in 1987 and again at wave 5, with current or most recent social class data used. The six-category variable at each wave was dichotomized into manual (VI,

V and III-M) and non-manual SEP (III-NM, II, I), thereby giving a possible score of 0, 1 or 2 (waves defined as being in a non-manual social class, i.e. higher SEP). The RGSC measure has been described as being “…(theoretically) a measure of prestige or social standing, (thus) it could be argued that the relation of this classification to health should be interpreted as due to the advantages bestowed by elevated social standing and increased prestige. In practice it

is often interpreted as an indicator of both social standing and material reward and resources” (Galobardes et al., 2006b). Data on car ownership, home ownership and income were based on self-report. Car ownership and home ownership, amongst other measures find more of household assets, have been hypothesized to be more direct indicators of material circumstances within the SEP construct (Davey-Smith and Egger, 1992). Both measures reflect income, but also access to resources and power (Carr-Hill et al., 1992). There may also be direct causal mechanisms between car/home ownership and health through for example, safer transport, changes in exposure to pollutants (positive and negative) or damp or overcrowded housing. It must also be noted that these measures have overlaps with behavioral, as well as MYO10 psychological and psychosocial, factors, for example, owning a car resulting in decreased physical activity (behavioral), but increased pride/self-esteem (psychosocial) (Macintyre et al., 1998). Income is linked to health through

multiple pathways including behavioral and psychological/psychosocial, (Benzeval et al., 2014) although the material pathway may be considered the primary driver through access to resources. Car ownership was based on a simple yes/no question. Respondents were classed as home renters if they rented their home either from social housing stock or from a private landlord (‘1’) or were classed as homeowners (‘0’). Income was based on monthly net household income, equivalised for household size and used as a continuous measure of British Pounds (£) per week. The top and bottom 1% of values on the income distribution were excluded (trimmed) to limit the effect of outliers, a common method when measuring income inequality (Cowell and Victoria-Feser, 1996).