Mortality in adults aged 26-54 years related to socioeconomic conditions in childhood and adulthood: post war birth cohort study.
OBJECTIVE
To examine premature mortality in adults in relation to socioeconomic conditions in childhood and adulthood.


METHODS
Nationally representative birth cohort study with prospective information on socioeconomic conditions.


METHODS
England, Scotland, and Wales. STUDY MEMBERS: 2132 women and 2322 men born in March 1946 and followed until age 55 years.


METHODS
Deaths between 26 and 54 years of age notified by the NHS central register.


RESULTS
Study members whose father's occupation was manual at age 4, or who lived in the worst housing, or who received the poorest care in childhood had double the death rate during adulthood of those living in the best socioeconomic conditions. All indicators of socioeconomic disadvantage at age 26 years, particularly lack of home ownership, were associated with a higher death rate. Manual origins and poor care in childhood remained associated with mortality even after adjusting for social class in adulthood or home ownership. The hazard ratio was 2.6 (95% confidence interval 1.5 to 4.4) for those living in manual households as children and as adults compared with those living in non-manual households at both life stages. The hazard ratio for those from manual origins who did not own their own home at age 26 years was 4.9 (2.3 to 10.5) compared with those from non-manual origins who were home owners.


CONCLUSIONS
Socioeconomic conditions in childhood as well as early adulthood have strongly influenced the survival of British people born in the immediate post war era.
Kuh
Diana
D
Medical Research Council National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and University College London, London WC1E 6BT. d.kuh@ucl.ac.uk
Hardy
Rebecca
R
Langenberg
Claudia
C
Richards
Marcus
M
Wadsworth
Michael E J
ME
D000328:Adult; D000367:Age Factors; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D017678:Sex Distribution; D012923:Social Class; D012959:Socioeconomic Factors; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology