IJE Advance Access originally published online on July 15, 2004
International Journal of Epidemiology 2004 33(5):1072-1079; doi:10.1093/ije/dyh224
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
IJE vol.33 no.5 © International Epidemiological Association 2004; all rights reserved.
Article |
Socioeconomic trajectories across the life course and health outcomes in midlife: evidence for the accumulation hypothesis?
International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK. E-mail: A.Singh-Manoux{at}public-health.ucl.ac.uk
Background Recent research in social epidemiology has established the importance of considering the accumulation of advantage and disadvantage across the life course when examining adult health outcomes. This paper examines (1) accumulation across trichotomous categories of socioeconomic position (SEP), and (2) accumulation in analysis stratified by adult SEP.
Methods Data are from the Whitehall II study. Each participant was categorized as having high (0), intermediate (1), or low (2) SEP at three time points in the life course, leading to 27 socioeconomic trajectories. These trajectories were summarized to yield a scale ranging from 0 (high SEP at all three time points) to 6 (low SEP at all three time points). Logistic regression was used to examine odds of incident coronary heart disease (CHD), poor mental and physical functioning, and minor psychiatric disorder.
Results There was a graded linear relationship between accumulation of socioeconomic exposure and health. Men with a score of 6 had increased odds of CHD (2.53, 95% CI: 1.3, 5.1), poor physical functioning (2.19, 95% CI: 1.4, 4.1), and poor mental functioning (2.60, 95% CI: 1.4, 4.9) compared with men with a score of 0. In women there was an accumulation effect for CHD and physical functioning. No cumulative effect of SEP on minor psychiatric disorder was observed. The effects of accumulation were weaker in analyses stratified by adult SEP, with early deprivation followed by high adult SEP particularly detrimental for CHD.
Conclusions The health effects of socioeconomic disadvantage accumulate over the life course. In addition to accumulation effects, analysis stratified by adult SEP also provided support for the critical period and the pathway model.
Keywords Life course, accumulation hypothesis, pathway model, critical period model, socioeconomic position, Whitehall II study
Accepted 5 April 2004
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. Tiikkaja and O. Hemstrom Does intergenerational social mobility among men affect cardiovascular mortality? A population-based register study from Sweden Scand J Public Health, August 1, 2008; 36(6): 619 - 628. [Abstract] [PDF]
|
|
|
|
 |
|
 F K Mensah and J Hobcraft Childhood deprivation, health and development: associations with adult health in the 1958 and 1970 British prospective birth cohort studies J. Epidemiol. Community Health, July 1, 2008; 62(7): 599 - 606. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Tabassum, M. Kumari, A. Rumley, G. Lowe, C. Power, and D. P. Strachan Effects of Socioeconomic Position on Inflammatory and Hemostatic Markers: A Life-Course Analysis in the 1958 British Birth Cohort Am. J. Epidemiol., June 1, 2008; 167(11): 1332 - 1341. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. W. Chi and C. M. Weisner Nine-Year Psychiatric Trajectories and Substance Use Outcomes: An Application of the Group-Based Modeling Approach Eval Rev, February 1, 2008; 32(1): 39 - 58. [Abstract] [PDF]
|
|
|
|
 |
|
 Response by Kneipp West J Nurs Res, November 1, 2007; 29(7): 893 - 895. [PDF]
|
|
|
|
 |
|
 A. Pickles Commentary: Trajectories, Selection and Cumulative Causation Int. J. Epidemiol., August 1, 2007; (2007) dym083v2. [Full Text] [PDF]
|
|
|
|
|
|
R Ljung and J Hallqvist Accumulation of adverse socioeconomic position over the entire life course and the risk of myocardial infarction among men and women: results from the Stockholm Heart Epidemiology Program (SHEEP). J. Epidemiol. Community Health, December 1, 2006; 60(12): 1080 - 1084. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E Ferrie, C. Langenberg, M. J Shipley, and M. G Marmot Birth weight, components of height and coronary heart disease: evidence from the Whitehall II study Int. J. Epidemiol., December 1, 2006; 35(6): 1532 - 1542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C R Chittleborough, F E Baum, A W Taylor, and J E Hiller A life-course approach to measuring socioeconomic position in population health surveillance systems. J. Epidemiol. Community Health, November 1, 2006; 60(11): 981 - 992. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Kauhanen, H.-M. Lakka, J. W Lynch, and J. Kauhanen Social disadvantages in childhood and risk of all-cause death and cardiovascular disease in later life: a comparison of historical and retrospective childhood information Int. J. Epidemiol., August 1, 2006; 35(4): 962 - 968. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D. Smith Infection, medical care and inequalities Int. J. Epidemiol., June 1, 2005; 34(3): 507 - 508. [Full Text] [PDF]
|
|
|
|
|
|
P. Virtanen, J. Vahtera, M. Kivimaki, V. Liukkonen, M. Virtanen, and J. Ferrie Labor Market Trajectories and Health: A Four-Year Follow-up Study of Initially Fixed-Term Employees Am. J. Epidemiol., May 1, 2005; 161(9): 840 - 846. [Abstract] [Full Text] [PDF]
|
|