International Journal of Epidemiology 2003;32:968-975
© International Epidemiological Association 2003
Special Theme: Mental Health |
Contribution of adolescent and early adult personality to the inverse association between education and cardiovascular risk behaviours: prospective population-based cohort study
1 Department of Psychology, Division of Applied Psychology, University of Helsinki, PO Box 9, FIN-00014 University of Helsinki, Finland.
2 Centre of Applied and Preventive Cardiology, Turku University, PO Box 52, 20251 Turku, Finland.
3 Department of Medicine, Turku University, PO Box 52, 20251 Turku, Finland.
Correspondence: Liisa Keltikangas-Järvinen. E-mail: liisa.keltikangas-jarvinen{at}helsinki.fi
Background The role of early personality in socioeconomic inequalities in health is not well understood. We investigated the extent to which type A components in adolescence and early adulthood contributed to the inverse association between education and behavioural cardiovascular disease risk factors in adulthood.
Methods Prospective cohort study with a population-based random sample of 477 men and 648 women, aged 12–21 years at baseline. Baseline data included information on pathogenic and protective components of type A behaviours (impatience, aggression, hard-driving, and engagement-involvement) and parental education. The 9-year follow-up data included information on the participant’s educational level and health behaviours (smoking, alcohol consumption, physical inactivity, butter use).
Results After adjustment for parental education, high levels of impatience and low levels of hard-driving in adolescence and early adulthood predicted low educational level in adulthood (Ps < 0.01 for men, Ps < 0.001 for women). Adulthood education was inversely associated with smoking in women and men (odds ratios [OR] = 8.5 and 7.9, 95% CI: 3.4–18.4 and 3.1–23.9, respectively), and with physical inactivity in women (OR = 5.4, 95% CI: 2.6–11.4). In men, components of type A behaviour explained 28.5% of the inverse association between education and smoking, even after controlling for parental education. In women, the corresponding proportions were 20.5% and 17.7% for smoking and physical inactivity, respectively.
Conclusions The inverse associations of adulthood education with smoking in men and women and physical inactivity in women may be partly rooted in personality-related factors present earlier in life. Our evidence suggests that personality should be studied as a potential contributor to socioeconomic differences in health behaviours.
Keywords Type A behaviour, socioeconomic status, health behaviour, cardiovascular risk
Accepted 24 January 2003
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