Cumulative (dis)advantage, employment turbulence and health: evidence from the German LifE study

This study uses longitudinal data from Germany to examine how socioeconomic position across the life course and employment stability are associated with self-rated health (SRH) in mid-adulthood, and whether employment stability compensates for cumulative disadvantage. While previous research has already sufficiently documented links between socioeconomic position in childhood and various health outcomes, long-term mechanisms across life courses remain less understood. To address this gap, the study adopts a life-course perspective that captures the accumulation of socioeconomic positions and employment trajectories over time. The national institutional context provides an interpretative framework for understanding how these trajectories unfold under the structural conditions of a liberalising, activation-oriented welfare state. Using data from the 2012 wave of the LifE study ('Pathways from Late Childhood to Adulthood'), the analysis combines a cumulative (dis)advantage index with an employment turbulence index and estimates linear regression models predicting SRH at 45. Results show a small but consistent negative association between cumulative disadvantage and SRH (β ≈ -0.05). Employment turbulence is likewise negatively associated with SRH (β ≈ -0.05 to -0.06), although this association is partly attenuated after adjustment for current employment. Interaction models provide limited support for a compensatory role of stability. Employment instability among socioeconomically advantaged individuals is associated with substantially lower predicted SRH (ΔSRH = -0.32), while the combination of cumulative disadvantage and instability shows the poorest SRH (ΔSRH = -0.34). The findings suggest that health inequalities in mid-adulthood reflect not only current circumstances, but also the accumulation of socioeconomic disadvantage and instability across the life course.