IJE Advance Access originally published online on January 25, 2007
International Journal of Epidemiology 2007 36(3):532-539; doi:10.1093/ije/dyl310
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Life-course influences on health in British adults: effects of socio-economic position in childhood and adulthood
1 Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
2 Division of Community Health Sciences, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
3 Centre for Longitudinal Studies, Bedford Group for Lifecourse and Statistical Studies, Institute of Education, 20 Bedford Way, London, WC1A 0AL, UK.
4 National Centre for Social Research, 35 Northampton Square, London, EC1V 0AX, UK.
5 MRC Hearing and Communication Group, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
6 Department of Clinical Biochemistry, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, NE1 4LP, UK.
7 Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK.
8 Division of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, Glasgow, G31 2ER, UK.
9 Aberdeen Pain Research Collaboration, Epidemiology Group, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
10 National Centre for Epidemiology and Population Health, Mills Road, The Australian National University, Canberra, ACT 0200, Australia.
11 Centre for Psychiatry, Queen Mary's School of Medicine and Dentistry, Charterhouse Square, London, EC1M 6BQ, US.
* Corresponding author. E-mail: c.power{at}ich.ucl.ac.uk
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Abstract |
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Background Little evidence exists on the role of socio-economic position (SEP) in early life on adult disease other than for cardiovascular mortality; data is often retrospective. We assess whether childhood SEP influences disease risk in mid-life, separately from the effect of adult position, and establish how associations vary across multiple measures of disease risk.
Methods Prospective follow-up to adulthood of all born in England, Scotland and Wales during 1 week in 1958, and with medical data at age 45 years (n = 9377). Outcomes include: blood pressure, body mass index (BMI), glycosylated haemoglobin (HbA1c), total and high density lipoprotein (HDL) cholesterol, triglycerides, fibrinogen, total immunoglobulin E (IgE), one-second forced expiratory volume (FEV1), hearing threshold (4 kHz), visual impairment, symptoms of depression and anxiety, chronic widespread pain.
Results Social class in childhood was associated with blood pressure, BMI, HbA1c, HDL cholesterol, triglycerides, fibrinogen, FEV1, hearing threshold, depressive symptoms and chronic widespread pain, with a general trend of deteriorating health from class I to V. Adult social class was also associated with these measures. Mutually adjusted analyses of child and adult social class suggest that both contribute to disease risk in mid-life: in general, associations for childhood class were as strong as for adult class. Individuals with a manual class at both time-points tended to have the greatest health deficits in adulthood.
Conclusions Adverse SEP in childhood is associated with a poorer health profile in mid-adulthood, independently of adult social position, and across diverse measures of disease risk and physical and mental functioning.
Keywords Social class, child and adult, cardio-respiratory disease, health inequalities, birth cohort
Accepted 19 December 2006
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