Perceived Social Mobility and Trajectories of Physical and Mental Health: An 18-Year Longitudinal Study

Background and Purpose

Socioeconomic status is a well-established determinant of health, yet individuals’ economic positions often change across the life course. Prior research on social mobility and health has two key limitations: a predominant reliance on objective indicators of mobility and a focus on health outcomes at a single time point. Less is known about how perceived social mobility shapes long-term health trajectories. This study examined how perceived economic mobility from childhood to midlife is associated with trajectories of physical and mental health over 18 years among Korean baby boomers.

Methods

This study used the data from 18 waves (2006–2023) of the Korea Welfare Panel Study, a nationally representative survey. The analytic sample included 1,924 individuals born between 1955 and 1963 (mean age at baseline = 46.8). Perceived social mobility was defined by cross-classifying self-reported household economic status in childhood and adulthood, resulting in four groups: Persistent Low (25.8%), Upward Mobility (22.6%), Downward Mobility (20.5%), and Persistent Middle (31.1%). Physical health was measured using dichotomized self-rated poor health, and mental health was assessed using the CESD-11 with a validated cutoff. Generalized linear mixed models were used to estimate trajectories over time, including linear and quadratic terms and interactions between time and mobility group, adjusting for sociodemographic covariates and time-varying poverty status.

Results

Distinct patterns emerged across outcomes. For subjective poor health, significant linear (OR = 1.17 (95% CI = 1.06–1.26)) and quadratic (OR = 1.17 (1.11–1.23)) effects indicated a U-shaped trajectory, with an initial decline followed by an accelerating increase. The turning point was estimated at age 53.6 (Wave 6.8). Compared with the Persistent Middle group, all other groups had higher odds of poor health: Persistent Low (OR = 3.54 (2.64–4.75)), Downward Mobility (OR = 3.10 (2.30–4.17)), and Upward Mobility (OR = 1.39 (1.02–1.89)). Significant quadratic interaction effects (Time^2 X group) were observed for the Persistent Low (OR = 1.22 (1.05–1.41)) and Downward Mobility (OR = 1.28 (1.09–1.51)) groups.

For depressive symptoms, significant linear (OR = 0.66 (0.61–0.71)) and quadratic (OR = 1.25 (1.18–1.32)) effects also indicated a U-shaped trajectory. The turning point occurred at age 56.3 (Wave 9.5). Persistent Low (OR = 3.86 (2.99–4.97)) and Downward Mobility (OR = 3.74 (2.89–4.83)) groups had higher odds of depressive symptoms than the Persistent Middle group, whereas the Upward Mobility group did not differ significantly. No significant interaction effects were observed.

Conclusions and Implications

Perceived social mobility had outcome-specific associations with health. Mobility shaped both the level and trajectory of physical subjective health, but its association with depressive symptoms was limited to overall levels, with no differences in trajectories. These findings highlight the importance of a life-course perspective on health inequality and suggest that efforts to reduce long-term physical health deterioration should address both early-life disadvantage and midlife economic instability. The findings underscore the dynamic nature of health inequalities and the need for longitudinal approaches in population health research.