The social gradient in preventive healthcare use: what can we learn from socially mobile individuals?

Little is known about the origins of the stratified nature of preventive health behaviour. In this paper, we introduce theory and methodology from the field of social mobility research. Intergenerational socially mobile individuals can provide insights into the central discussion about how health lifestyles or cultural health capital develop over the life course, as they have encountered different contexts of socialisation, each with its own characteristic health-related practices. We study the use of regular mammography screening by Belgian women using data from the Survey of Health, Aging and Retirement and we operationalise social mobility as occupational mobility using the International Standard Classification of Occupations (ISCO-88). By means of diagonal reference models, we are able to discern the effects of the social position of origin, the social position of destination and social mobility itself, contrary to the less rigorous linear regression approach that prevails in health behaviour research. As expected, the take up of mammography screening is strongly influenced by social position. It seems that both upwardly and downwardly mobile women adapt to the mammography screening practices in their position of destination. This study shows the potential for social mobility research to enrich the debate on health lifestyles.