Social inequalities in health are observed in all societies. These inequalities have grown markedly over the past 30 years, with those in less advantaged social positions currently expected to live 5–10 years less than those in more advantaged positions. The study aims to establish the root causes of these inequalities by (1) assessing the drivers of long-term changes in health inequalities and establishing the contribution of family factors and macro-level social and economic conditions to these changes; (2) examining multigenerational interdependencies of social position and health in up to four generations; (3) estimating the causal effects of social position on health by employing molecular genetic information and assessing whether genetic associations are mediated or modified by social position; (4) evaluating the generalisability of explanations of social inequalities in health through international comparative research. The study will integrate research scattered in multiple disciplines by establishing how family background – both social as experienced through living conditions and social resources in families, and genetic as inherited from biological parents – affects health and social disadvantage within and across generations. The project will go beyond standard observational research through new conceptual insight and by using a unique combination of longitudinal register-based and genetically informed data sources. We will take advantage of natural experiments – educational and alcohol policy reforms and rapid economic changes – to identify pivotal social processes in the production of health inequalities. Our results will be ground-breaking because we will establish how family and genetic factors are intertwined with individual social characteristics and how they manifest in health outcomes in different macro-level social conditions. The power to test causal hypotheses will advance science and help devise policies to reduce health inequalities.
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