Socio-economic differences in mortality among children. Do they persist into adulthood?

Abstract

More than 1.2 million Swedish children born 1946–1960 and enumerated in the 1960 population census were followed up with respect to mortality for the period 1961–1979. Thus the children were younger than 15 years at the start of the follow-up and their age of death varied between 1 and 33 years. More than 13,000 deaths were analysed. The purpose was to examine whether or not mortality differences by socio-economic group in childhood persist into adulthood. Mortality differences by childhood socio-economic group were studied for both children/adolescents (1–19 years old) and young adults (20–33 years old). Information about the adults' own occupational status was not available. Therefore, to allow a deeper analysis, another group of adults, whose mortality could be analysed by their own socio-economic group, was used as a comparison group. Among children and adolescents there was a clear socio-economic group difference in mortality. Children in families of non-manual workers had a significantly lower mortality than children in the families of manual workers. In particular this was the case for boys. Socio-economic differences in total mortality are evident also in the age between 20 and 33 years among men but it could not be demonstrated here that these are a result of childhood socio-economic group rather than achieved socio-economic group. However, the study indicates that some differences in childhood, to a certain degree and for some diagnoses, may persist into adulthood. Of particular interest may be a tendency for cardiovascular disease mortality to be elevated among sons and daughters of manual workers. We conclude that this question is worth further attention.