Lifecourse influences on health among British adults: effects of region of residence in childhood and adulthood.
BACKGROUND
It has been suggested that early life exposures are important determinants of geographical variations in adult diseases. We examined inter-regional migrants in Britain to evaluate the relative importance of early and recent exposures for adult cardiorespiratory risk factors, mental ill-health and sensory function.


METHODS
A total of 9023 persons born throughout England, Scotland and Wales during 1 week in 1958 were followed periodically through childhood into adulthood. At 44-45 years, height, body mass index (BMI), blood pressure (BP), glycosylated haemoglobin, total and high-density lipoprotein (HDL) cholesterol, triglycerides, fibrinogen, total immunoglobulin E (IgE), one-second forced expiratory volume (FEV1), hearing threshold at 4 kHz, visual impairment, symptoms of depression and anxiety, and chronic widespread pain were measured. Analysis of migration between 12 regions included 3125 cohort members who were examined in a region different to their birthplace.


RESULTS
Height, BMI, diastolic BP (DBP), FEV1, log-transformed IgE and hearing threshold varied by region among non-migrants (each P < 0.05). Among inter-regional migrants, the spatial associations with current region, independent of birthplace, followed closely the geographical pattern shown among non-migrants for BMI, DBP and FEV1 (each P < 0.001). In contrast, of the 15 outcomes, only adult height was related to region of birth, after adjustment for region of examination (P = 0.002)


CONCLUSIONS
Although individual disease risk is predicted by early life factors, early exposures do not explain regional variations in cardiovascular and respiratory risk factors among middle-aged adults in Britain. Geographical inequalities in cardiorespiratory health are more strongly related to factors associated with region of examination that influence obesity, BP and ventilatory function.
Strachan
David P
DP
Division of Community Health Sciences, St George's University of London, Cranmer Terrace, London, UK. d.strachan@sgul.ac.uk
Rudnicka
Alicja R
AR
Power
Chris
C
Shepherd
Peter
P
Fuller
Elizabeth
E
Davis
Adrian
A
Gibb
Ian
I
Kumari
Meena
M
Rumley
Ann
A
Macfarlane
Gary J
GJ
Rahi
Jugnoo
J
Rodgers
Bryan
B
Stansfeld
Stephen
S
D000328:Adult; D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007231:Infant, Newborn; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D012111:Residence Characteristics; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology; D012606:Scotland / Q000453:epidemiology; D014171:Transients and Migrants; D014852:Wales / Q000453:epidemiology
D007073:Immunoglobulin E