IJE Advance Access published online on January 25, 2007
International Journal of Epidemiology, doi:10.1093/ije/dyl309
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Lifecourse influences on health among British adults: Effects of region of residence in childhood and adulthood
1 Division of Community Health Sciences St George's University of London, Cranmer Terrace, London SW17 0RE, UK.
2 Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, UCL, 30 Guilford Street, London WC1N 1EH, 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, Newcastle, NE1 4LP, UK.
7 Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London, WC1E 6BT, UK.
8 Division of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, 10 Alexandra Parade, 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, UK.
* Corresponding author: Division of Community Health Sciences, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK. E-mail: d.strachan{at}sgul.ac.uk
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Abstract |
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Background It has been suggested that early life exposures are important determinants of geographical variations in adult diseases. We examined inter-regional migrants in Britain to evaluate the relative importance of early and recent exposures for adult cardiorespiratory risk factors, mental ill-health and sensory function.
Methods A total of 9023 persons born throughout England, Scotland and Wales during 1 week in 1958 were followed periodically through childhood into adulthood. At 44–45 years, height, body mass index (BMI), blood pressure (BP), glycosylated haemoglobin, total and high-density lipoprotein (HDL) cholesterol, triglycerides, fibrinogen, total immunoglobulin E (IgE), one-second forced expiratory volume (FEV1), hearing threshold at 4 kHz, visual impairment, symptoms of depression and anxiety, and chronic widespread pain were measured. Analysis of migration between 12 regions included 3125 cohort members who were examined in a region different to their birthplace.
Results Height, BMI, diastolic BP (DBP), FEV1, log-transformed IgE and hearing threshold varied by region among non-migrants (each P < 0.05). Among inter-regional migrants, the spatial associations with current region, independent of birthplace, followed closely the geographical pattern shown among non-migrants for BMI, DBP and FEV1 (each P < 0.001). In contrast, of the 15 outcomes, only adult height was related to region of birth, after adjustment for region of examination (P = 0.002)
Conclusions Although individual disease risk is predicted by early life factors, early exposures do not explain regional variations in cardiovascular and respiratory risk factors among middle-aged adults in Britain. Geographical inequalities in cardiorespiratory health are more strongly related to factors associated with region of examination that influence obesity, BP and ventilatory function.
Keywords Birth cohort, health inequalities, geographical variation, migration
Accepted 2 November 2006
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