Abstract
ObjectivesChildhood conditions have been recognised as important predictors of short-term and long-term health outcomes, but few studies have considered status position in the peer group as a possible determinant of adult health. Lower peer status, which often reflects experiences of marginalisation and rejection by peers, may impose inequality experiences and leave long-lasting imprints on health. The present study aimed to examine whether peer status is associated with the risk for circulatory disease in adulthood.DesignProspective cohort study based on the Stockholm Birth Cohort Multigenerational Study(SBC Multigen).SettingStockholm metropolitan area.ParticipantsAll individuals who were born in 1953 and resident in the greater metropolitan area of Stockholm in 1963 (n=14 608). The analytical sample consisted of 5410 males and 5990 females. Peer status was sociometrically assessed in cohort members at age 13. The survey material was linked to inpatient care registers that contained information about circulatory diseases (n=1668) across ages 20–63. Cox proportional hazard models were used for the analysis.Outcome measureCirculatory disease.ResultsPeer marginalisation at age 13 resulted in significantly higher risks of circulatory disease in adulthood among males (HR 1.34; 95% CI 1.09 to 1.64) and females (HR 1.33; 95% CI 1.04 to 1.70) alike. A graded relationship between peer status and circulatory diseases was detected in females (p=0.023). Among males there was a threshold effect, showing that only those in the lowest status position had significantly increased risks of circulatory disease. The associations remained significant after adjusting for various conditions in childhood and adulthood.ConclusionsThis study shows that circulatory diseases in adulthood may be traceable to low peer status and marginalisation in childhood. It is suggested that peer status in late childhood may precede social integration in adolescence and adulthood, acting as a long-term stressor that contributes to circulatory disease through biological, behavioural and psychosocial pathways.
Highlights
Innumerable studies have demonstrated the importance of childhood conditions for later life outcomes and, within health inequality
Based on data from a Swedish cohort born in 1953 who have been followed for more than 60 years, the present study examines the association between sociometrically assessed peer status in childhood and circulatory disease during adulthood
The descriptive statistics are shown in table 1 and illustrate a higher prevalence of circulatory diseases for males (18.5%; n=999) than for females (11.2%; n=669)
Summary
Childhood conditions have been recognised as important predictors of short-term and long-term health outcomes, but few studies have considered status position in the peer group as a possible determinant of adult health. The present study aimed to examine whether peer status is associated with the risk for circulatory disease in adulthood. Participants All individuals who were born in 1953 and resident in the greater metropolitan area of Stockholm in 1963 (n=14 608). Results Peer marginalisation at age 13 resulted in significantly higher risks of circulatory disease in adulthood among males (HR 1.34; 95% CI 1.09 to 1.64) and females (HR 1.33; 95% CI 1.04 to 1.70) alike. Conclusions This study shows that circulatory diseases in adulthood may be traceable to low peer status and marginalisation in childhood. It is suggested that peer status in late childhood may precede social integration in adolescence and adulthood, acting as a long-term stressor that contributes to circulatory disease through biological, behavioural and psychosocial pathways
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