Abstract
BACKGROUND: Evidence on health inequalities among young people is patchy compared to that among adults and younger children. This study examined the association between self-rated general health and a family's socioeconomic position among 10-24 year olds. METHODS: We utilised 2001, 2011 and 2021 census microdata from England and Wales, and 2001 and 2011 data from Scotland. Descriptive methods were used to determine differences in general health status by sociodemographic variables, and logistic regression analysis to calculate the odds of reporting poor health according to the National Statistics Socio-economic Classification (NS-SEC) of the household reference person (HRP). Logistic regression models controlled for the effects of age, gender, household-level deprivation of education and housing, and UK region. RESULTS: We observed the same socioeconomic patterning of health over the period of twenty years. All occupational groups had higher rates of poor health compared to the least disadvantaged group of young people. Compared to young people from households where the HRP belonged to the managerial or professional NS-SEC group, all other groups, except those self-employed in 2001, had greater odds of reporting poor health. The odds were highest among young people from households where the HRP had never worked or was long-term unemployed: 2.7 times in 2001, 3.1 times in 2011 and 3.6 times in 2021 (p < 0.001). CONCLUSIONS: We observed a similar social gradient of self-reported poor health across the 2001, 2011 and 2021 census datasets; as disadvantage increased, the share of young people with fair or poor health increased. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12982-025-00975-y.