title: Socially isolated children 20 years later: risk of cardiovascular disease.
abstract: OBJECTIVE
  To test the hypothesis that children who occupy peripheral or isolated roles in their peer groups (isolated children) are at risk of poor adult health.
  
  
  METHODS
  Longitudinal study of an entire birth cohort.
  
  
  METHODS
  Dunedin, New Zealand.
  
  
  METHODS
  A total of 1037 children who were followed up from birth to age 26 years.
  
  
  METHODS
  Measurement of social isolation in childhood, adolescence, and adulthood.
  
  
  METHODS
  When study members were 26 years old, we measured adult cardiovascular multifactorial risk status (overweight, elevated blood pressure, elevated total cholesterol level, low high-density lipoprotein level, elevated glycated hemoglobin concentration, and low maximum oxygen consumption).
  
  
  RESULTS
  Socially isolated children were at significant risk of poor adult health compared with nonisolated children (risk ratio, 1.37; 95% confidence interval, 1.17-1.61). This association was independent of other well-established childhood risk factors for poor adult health (low childhood socioeconomic status, low childhood IQ, childhood overweight), was not accounted for by health-damaging behaviors (lack of exercise, smoking, alcohol misuse), and was not attributable to greater exposure to stressful life events. In addition, longitudinal findings showed that chronic social isolation across multiple developmental periods had a cumulative, dose-response relationship to poor adult health (risk ratio, 2.58; 95% confidence interval, 1.46-4.56).
  
  
  CONCLUSIONS
  Longitudinal findings about children followed up to adulthood suggest that social isolation has persistent and cumulative detrimental effects on adult health. The findings underscore the usefulness of a life-course approach to health research, by focusing attention on the effect of the timing of psychosocial risk factors in relation to adult health.
authors.affiliation: Author Affiliations: Department of Psychology, University of Wisconsin, Madison, USA. a.caspi@iop.kcl.ac.uk
authors.forename: Avshalom
authors.initials: A
authors.lastname: Caspi
authors.forename: Honalee
authors.initials: H
authors.lastname: Harrington
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Moffitt
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Milne
authors.forename: Richie
authors.initials: R
authors.lastname: Poulton
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D000328:Adult; D002318:Cardiovascular Diseases / Q000523:psychology*; D002648:Child; D002657:Child Development; D005260:Female; D015438:Health Behavior; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D012934:Social Isolation