Background: Childhood and current economic difficulties are associated with physical health. However, evidence concerning the factors underlying these associations is sparse. This study examines the contribution of a range of social and behavioural factors to associations between economic difficulties and physical functioning. Methods: We used comparable data on middle-aged white-collar employees from the Finnish Helsinki Health Study cohort (n=3843) and the British Whitehall II Study cohort (n=3052). Our health outcome was physical functioning measured by the SF-36 Physical Component Summary. Relative indices of inequality (RII), calculated using logistic regression analysis, were used to examine associations between economic difficulties and physical functioning, and the contribution of further socio-economic circumstances, health behaviours, living arrangements and work–family conflicts to these associations. Results: In age-adjusted models, childhood (RII=1.76−3.06) and current (RII=1.79−3.03) economic difficulties were associated with poor physical functioning in both cohorts. Further adjusting for work–family conflicts attenuated the associations of current economic difficulties with physical functioning in both cohorts, and also those of childhood economic difficulties in the Helsinki cohort. Adjustments for other socio-economic circumstances also caused some attenuation, while health behaviours and living arrangements had small or negligible effects. Conclusions: Conflicts between work and family contribute to the associations of economic difficulties with physical functioning among employees from Finland and Britain. This suggests that supporting people to cope with economic difficulties, and efforts to improve the balance between paid work and family may help employees maintain good physical functioning.
Keywords: comparisons, employees, physical functioning, SF-36, socio-economic position