Association between children's experience of socioeconomic disadvantage and adult health: a life-course study.
BACKGROUND
Research into social inequalities in health has tended to focus on low socioeconomic status in adulthood. We aimed to test the hypothesis that children's experience of socioeconomic disadvantage is associated with a wide range of health risk factors and outcomes in adult life.


METHODS
We studied an unselected cohort of 1000 children (born in New Zealand during 1972-73) who had been assessed at birth and ages 3, 5, 7, 9, 11, 13, and 15 years. At age 26 years, we assessed these individuals for health outcomes including body-mass index, waist:hip ratio, blood pressure, cardiorespiratory fitness, dental caries, plaque scores, gingival bleeding, periodontal disease, major depression, and tobacco and alcohol dependence, and tested for associations between these variables and childhood and adult socioeconomic status.


RESULTS
Compared with those from high socioeconomic status backgrounds, children who grew up in low socioeconomic status families had poorer cardiovascular health. Significant differences were also found on all dental health measures, with a threefold increase in adult periodontal disease (31.1% vs 11.9%) and caries level (32.2% vs 9.9%) in low versus high childhood socioeconomic status groups. Substance abuse resulting in clinical dependence was related in a similar way to childhood socioeconomic status (eg, 21.5% vs 12.1% for adult alcohol dependence). The longitudinal associations could not be attributed to life-course continuity of low socioeconomic status, and upward mobility did not mitigate or reverse the adverse effects of low childhood socioeconomic status on adult health.


CONCLUSIONS
Protecting children against the effects of socioeconomic adversity could reduce the burden of disease experienced by adults. These findings provide strong impetus for policy makers, practitioners, and researchers to direct energy and resources towards childhood as a way of improving population health.
Poulton
Richie
R
Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand. richiep@gandalf.otago.ac.nz
Caspi
Avshalom
A
Milne
Barry J
BJ
Thomson
W Murray
WM
Taylor
Alan
A
Sears
Malcolm R
MR
Moffitt
Terrie E
TE
D000328:Adult; D002648:Child; D015986:Confounding Factors, Epidemiologic; D003625:Data Collection; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008603:Mental Health; D009520:New Zealand; D009909:Oral Health; D011203:Poverty; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors