Social Science & Medicine 58 (2004) 2171–2179 Life course influences on quality of life in early old age D. Blane a, *, P. Higgs b , M. Hyde a , R.D. Wiggins c a Department of Social Science and Medicine, Imperial College London, St. Dunstan’s Road, London W6 8RP, UK b Department of Psychiatry and Behavioural Science, University College London, Gower Street, London WCIE 6BT, UK c Department of Sociology, City University, Northampton Square, London, ECIV OHB, UK Abstract A growing literature demonstrates life course influences on health in early old age. The present paper is the first to examine whether similar processes also influence quality of life in early old age. The question is theorised in terms of structured dependency and third age, and the life course pathways by which people arrive at these destinations in later life. The issues are investigated in a unique data set that contains health and life course information on some 300 individuals mostly aged 65–75 years, enhanced in 2000 by postal survey data on quality of life. Several types of life course effect are identified at conventional levels of statistical significance. Long-term influences on quality of life, however, are less marked than those on health. Quality of life in early old age appears to be influenced primarily by current contextual factors such as material circumstances and serious health problems, with the influence of the life course limited mostly to its shaping of an individual’s circumstances in later life. The implication for policy is that disadvantage during childhood and adulthood does not preclude good quality of life in early old age. r 2003 Elsevier Ltd. All rights reserved. Keywords: Early old age; Quality of life; Life course; UK Introduction There is a growing literature which demonstrates life course influences on later health (Kuh & Ben-Shlomo 1997; Kuh & Hardy 2002). Clinically significant increases in systolic blood pressure, for example, are found among those in early old age 1 who grew slowly when they were children (Montgomery, Berney, & Blane, 2000), especially if after childhood they worked for many years in occupations with low job control (Berney, Blane, Davey Smith, & Holland, 2000). Material and psycho-social deprivation during child- hood, which slow growth, followed by repetitive and highly supervised work in adulthood illustrate the process of life course accumulation of disadvantage. It is biologically plausible that health at later ages is influenced by this social process of accumulating disadvantage. The body can be seen as a mechanism which stores the past benefits and dis-benefits to which it has been exposed, either because damage at a critical period of development causes irreparable loss (Barker, 1994) or because the effects of various types of damage accumulate over time (Mann, Wadsworth, & Colley, 1992). The present paper is concerned with the question of whether quality of life in early old age similarly is influenced by earlier events. Although it appears less rooted in biology than health, life course influences on quality of life would be plausible. In addition to health, with its own well-documented life course influences, quality of life in early old age is known to be influenced by family contact and financial well-being (Farquar, 1995; Bowling, 1995; Ginn & Arber, 1999; Evandrou & Falkingham, 2000), which also could have their origins ARTICLE IN PRESS *Corresponding author. Tel.: +44-20-7594-0789; fax: +44- 20-7594-0866. E-mail address: d.blane@imperial.ac.uk (D. Blane). 1 The term ‘early old age’ is used in the present paper to refer to the period of life which stretches between labour market exit and the onset of physical dependency. It describes a phase of the life course, rather than precise chronological ages. In chronological terms it is subject to considerable individual variation and to an historical tendency to start earlier and end later. In present day Britain, however, it could be seen generally as starting in a person’s late 50s or early 60s and ending in their late 70s or early 80s. 0277-9536/$-see front matter r 2003 Elsevier Ltd. All rights reserved. doi:10.1016/j.socscimed.2003.08.028