Life-course influences on health in British adults: effects of socio-economic position in childhood and adulthood.
BACKGROUND
Little evidence exists on the role of socio-economic position (SEP) in early life on adult disease other than for cardiovascular mortality; data is often retrospective. We assess whether childhood SEP influences disease risk in mid-life, separately from the effect of adult position, and establish how associations vary across multiple measures of disease risk.


METHODS
Prospective follow-up to adulthood of all born in England, Scotland and Wales during 1 week in 1958, and with medical data at age 45 years (n = 9377). Outcomes include: blood pressure, body mass index (BMI), glycosylated haemoglobin (HbA1c), total and high density lipoprotein (HDL) cholesterol, triglycerides, fibrinogen, total immunoglobulin E (IgE), one-second forced expiratory volume (FEV1), hearing threshold (4 kHz), visual impairment, symptoms of depression and anxiety, chronic widespread pain.


RESULTS
Social class in childhood was associated with blood pressure, BMI, HbA1c, HDL cholesterol, triglycerides, fibrinogen, FEV1, hearing threshold, depressive symptoms and chronic widespread pain, with a general trend of deteriorating health from class I to V. Adult social class was also associated with these measures. Mutually adjusted analyses of child and adult social class suggest that both contribute to disease risk in mid-life: in general, associations for childhood class were as strong as for adult class. Individuals with a manual class at both time-points tended to have the greatest health deficits in adulthood.


CONCLUSIONS
Adverse SEP in childhood is associated with a poorer health profile in mid-adulthood, independently of adult social position, and across diverse measures of disease risk and physical and mental functioning.
Power
Chris
C
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London, UK. c.power@ich.ucl.ac.uk
Atherton
Kate
K
Strachan
David P
DP
Shepherd
Peter
P
Fuller
Elizabeth
E
Davis
Adrian
A
Gibb
Ian
I
Kumari
Meena
M
Lowe
Gordon
G
Macfarlane
Gary J
GJ
Rahi
Jugnoo
J
Rodgers
Bryan
B
Stansfeld
Stephen
S
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006304:Health Status; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007231:Infant, Newborn; D008055:Lipids / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology; D012606:Scotland / Q000453:epidemiology; D012923:Social Class; D014852:Wales / Q000453:epidemiology
D006442:Glycated Hemoglobin; D007073:Immunoglobulin E; D008055:Lipids; C517652:hemoglobin A1c protein, human