Whitehall Study - Whitehall II

Twenty years later, the Whitehall II study documented a similar gradient in morbidity in women as well as men. The name Whitehall II was derived from the previous Whitehall study. The Whitehall Studies revealed this social gradient for a range of different diseases: heart disease, some cancers, chronic lung disease, gastrointestinal disease, depression, suicide, sickness absence, back pain and general feelings of ill-health. A major challenge, and a reason for the importance of these studies, was to understand the causes of this social distribution of so many disorders.

Whitehall II is a longitudinal, prospective cohort study of 10,308 women and men, all of whom were employed in the London offices of the British Civil Service at the time they were recruited to the study in 1985. The initial data collection included a clinical examination and self-report questionnaire. Since then, nine waves of data collection have been completed: phase 1 (1984-1985; age 35 to 55), phase 2 (1989-1990), phase 3 (1991-1993), phase 4 (1995-1996), phase 5 (1997-1999), phase 6 (2001), phase 7 (2002-2004), phase 8 (2006), phase 9 (2007-2009) and phase 10 (2011). The tenth wave began in January 2011, with wave 11 due to begin in January 2012. The study continues to release findings.

The study covers a wide age range, starting at 35 at recruitment and ending at 80 by phase 9:

• phase 1 (age 35 to 55)
• phase 2 (age 37 to 60)
• phase 3 (age 39 to 64)
• phase 4 (age 42 to 65)
• phase 5 (age 45 to 69)
• phase 6 (age 48 to 71)
• phase 7 (age 50 to 74)
• phase 8 (age 53 to 76)
• phase 9 (age 55 to 80)
• phase 10
• phase 11

Research continues to explore the pathways and mechanisms through which social position influences health. The research group aims to build a causal model leading from social position through psychosocial and behavioural pathways to pathophysiological changes, sub-clinical markers of disease, functional change, and clinical disease.

The Whitehall II study began as a study of working age people and investigated the relationships between work, stress, and health. Whitehall II found that the way work is organised, the work climate, social influences outside work, influences from early life, and health behaviours all contribute to the social gradient in health. As participants in this study continue through adult life, the research focuses on inequalities in health and functioning in an aging population. With an increasingly large population of older citizens in the UK, there is an urgent need to identify the causes of social inequalities and to study the long term effects of previous circumstances on people’s ability to function and stay healthy during retirement. Researchers in the Whitehall II team are also considering the role of social inequalities in relation to dementia risk.