title: Effects of childhood socioeconomic position on subjective health and health behaviours in adulthood: how much is mediated by adult socioeconomic position?
abstract: BACKGROUND
  Adult socioeconomic position (SEP) is one of the most frequently hypothesised indirect pathways between childhood SEP and adult health. However, few studies that explore the indirect associations between childhood SEP and adult health systematically investigate the mediating role of multiple individual measures of adult SEP for different health outcomes. We examine the potential mediating role of individual measures of adult SEP in the associations of childhood SEP with self-rated health, self-reported mental health, current smoking status and binge drinking in adulthood.
  
  
  METHODS
  Data came from 10,010 adults aged 25-64 years at Wave 3 of the Survey of Family, Income and Employment in New Zealand. The associations between childhood SEP (assessed using retrospective information on parental occupation) and self-rated health, self-reported psychological distress, current smoking status and binge drinking were determined using logistic regression. Models were adjusted individually for the mediating effects of education, household income, labour market activity and area deprivation.
  
  
  RESULTS
  Respondents from a lower childhood SEP had a greater odds of being a current smoker (OR 1.70 95% CI 1.42-2.03), reporting poorer health (OR 1.82 95% CI 1.39-2.38) or higher psychological distress (OR 1.60 95% CI 1.20-2.14) compared to those from a higher childhood SEP. Two-thirds to three quarters of the association of childhood SEP with current smoking (78%), and psychological distress (66%) and over half the association with poor self-rated health (55%) was explained by educational attainment. Other adult socioeconomic measures had much smaller mediating effects.
  
  
  CONCLUSIONS
  This study suggests that the association between childhood SEP and self-rated health, psychological distress and current smoking in adulthood is largely explained through an indirect socioeconomic pathway involving education. However, household income, area deprivation and labour market activity are still likely to be important as they are intermediaries in turn, in the socioeconomic pathway between education and health.
authors.affiliation: Health Inequalities Research Programme, Department of Public Health, University of Otago, Wellington, New Zealand. sarah.mckenzie@otago.ac.nz
authors.forename: Sarah K
authors.initials: SK
authors.lastname: McKenzie
authors.forename: Kristie N
authors.initials: KN
authors.lastname: Carter
authors.forename: Tony
authors.initials: T
authors.lastname: Blakely
authors.forename: Vivienne
authors.initials: V
authors.lastname: Ivory
mesh_terms: D000328:Adult; D015984:Causality; D016001:Confidence Intervals; D003625:Data Collection; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D016017:Odds Ratio; D012189:Retrospective Studies; D012923:Social Class