Adverse socioeconomic conditions in childhood and cause specific adult mortality: prospective observational study.
OBJECTIVE
To investigate the association between social circumstances in childhood and mortality from various causes of death in adulthood.


METHODS
Prospective observational study.


METHODS
27 workplaces in the west of Scotland.


METHODS
5645 men aged 35-64 years at the time of examination.


METHODS
Death from various causes.


RESULTS
Men whose fathers had manual occupations when they were children were more likely as adults to have manual jobs and be living in deprived areas. Gradients in mortality from coronary heart disease, stroke, lung cancer, stomach cancer, and respiratory disease were seen (all P<0.05), generally increasing from men whose fathers had professional and managerial occupations (social class I and II) to those whose fathers had semiskilled and unskilled manual occupations (social class IV and V). Relative rates of mortality adjusted for age for men with fathers in manual versus non-manual occupations were 1.52 (95% confidence interval 1.24 to 1.87) for coronary heart disease, 1.83 (1.13 to 2. 94) for stroke, 1.65 (1.12 to 2.43) for lung cancer, 2.06 (0.93 to 4. 57) for stomach cancer, and 2.01 (1.17 to 3.48) for respiratory disease. Mortality from other cancers and accidental and violent death showed no association with fathers' social class. Adjustment for adult socioeconomic circumstances and risk factors did not alter results for mortality from stroke and stomach cancer, attenuated the increased risk of coronary heart disease and respiratory disease, and essentially eliminated the association with lung cancer.


CONCLUSIONS
Adverse socioeconomic circumstances in childhood have a specific influence on mortality from stroke and stomach cancer in adulthood, which is not due to the continuity of social disadvantage throughout life. Deprivation in childhood influences risk of mortality from coronary heart disease and respiratory disease in adulthood, although an additive influence of adulthood circumstances is seen in these cases. Mortality from lung cancer, other cancer, and accidents and violence is predominantly influenced by risk factors that are related to social circumstances in adulthood.
Smith
G D
GD
Department of Social Medicine, University of Bristol, Canynge Hall, Bristol BS8 2PR. zetkin@bristol.ac.uk
Hart
C
C
Blane
D
D
Hole
D
D
D000059:Accidents / Q000706:statistics & numerical data*; D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000401:mortality; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011203:Poverty; D011446:Prospective Studies; D012120:Respiration Disorders / Q000401:mortality*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012923:Social Class; D012959:Socioeconomic Factors; D013274:Stomach Neoplasms / Q000401:mortality; D014754:Violence / Q000706:statistics & numerical data*; D017132:Workplace