The chronic illnesses of old age strike manual workers up to two decades before their better-paid managers, say University College London researchers.
Manual workers suffer illness sooner than their bosses
The finding reinforces the link between income and long-term health.
The English Longitudinal Study on Ageing, found a third of manual workers aged 50 to 59 reported a long-standing illness.
Bosses only started suffering similar illnesses in the same numbers after the age of 75.
Leading the study was Professor Sir Michael Marmot, head of the International Centre for Health and Society at UCL, and focused on a group of more than 12,000 people.
The Institute for Fiscal Studies and the National Centre for Social Research also contributed to the project.
It monitored the health of the group over a period of more than two decades.
Manual workers, it found, were far more likely to suffer heart disease and mental health problems than professional classes.
People from poorer households are more likely to have a poor diet, to smoke.
Those in richer households were most likely to drink moderate amounts of alcohol - which is now thought to offer protection against some diseases.
The study reveals that in England, one fifth of those aged over 50 have only £1,000 or less in savings - 10% have an average of £140,000.
The poorest in terms of savings were six times more likely to have poor mobility compared with the richest.
Professor Hilary Graham, an expert in social policy from the University of Lancaster, told BBC News Online that there was hope that this health gap could be narrowed.
She said: "A lot of people think there is nothing that can be done about these inequalities.
"However, we know what can be achieved because of the high levels of health of the bosses, who are working in the same industry - we can look at what advantages they have got and make them more widely available. One of these could be better working conditions.
"Of course, we have to remember that we are all a lot healthier than we were 100 years ago."
She said that the move from manufacturing towards service industry jobs would not necessarily mean better health, as some research suggested that workers who had less control over their working lives were more prone to chronic illness.