Abstract
BackgroundDisadvantageous socioeconomic conditions (SEC) in both childhood and adulthood increase the risk of stroke. We investigated whether intergenerational and lifetime social advancement decreases and/or social descent increases stroke risk.MethodsIn a case-control study with 466 patients with first-ever ischemic stroke and 807 controls randomly selected from the general population, we compared paternal profession to subjects’ professional education in adolescence and their last profession in adulthood. Furthermore, we constructed a socioeconomic risk score for childhood (based on paternal and maternal profession and occupation, familial, living and material conditions), adolescence (based on highest school degree and professional education), and adulthood (based on last profession, periods of unemployment, and marital status), and compared subjects´ positions at different life stages. Odds ratios were derived based on conditional logistic regression conditioning on age and sex only, after adjustment for medical and lifestyle risk factors, and after additional adjustment for socioeconomic risk score values.ResultsIntergenerational upward mobility between paternal profession and subject’s professional education was associated with lower ischemic stroke risk independent of medical and lifestyle risk factors (odds ratio (OR) 0.58; 95% confidence interval (CI) 0.41–0.81) and after additional adjustment for socioeconomic conditions in all three life stages (OR 0.67; 95% CI 0.45–0.99). Advancement between fathers´ profession and subject’s last profession was associated with reduced odds of stroke after adjustment for risk factors (OR 0.65; 95% CI 0.47–0.89), but not significantly after additional adjustment for SEC (OR 0.77; 95% CI 0.52–1.13). Social descent between adolescence and adulthood indicated by the transition into a more disadvantageous tertile of socioeconomic risk score was associated with increased odds of stroke after adjustment for all risk factor (OR 2.93; 95% CI 1.21–7.13). Analyses by sex revealed mostly similar results in men and women with only few potential differences.ConclusionsOur study results indicate that aspects of social downward mobility during adulthood may be associated with increased risk of stroke, whereas intergenerational upward mobility may be linked to a lower stroke risk. If confirmed by future studies, such results may help to focus stroke prevention measures at high risk populations.
Highlights
Disadvantageous socioeconomic conditions (SEC) in both childhood and adulthood increase the risk of stroke
We reported that disadvantageous socioeconomic conditions (SEC) in childhood are independently associated with higher risk of ischemic stroke later in adulthood [3]
Professional advancement in adolescence as compared to paternal profession was associated with a reduced risk of stroke after adjustment for all stroke risk factors and socioeconomic status in childhood, adolescence, and later adulthood
Summary
Disadvantageous socioeconomic conditions (SEC) in both childhood and adulthood increase the risk of stroke. We reported that disadvantageous socioeconomic conditions (SEC) in childhood are independently associated with higher risk of ischemic stroke later in adulthood [3]. Social upward mobility as compared to the parental generation and during own adulthood may be associated with higher self-consciousness and better health awareness and may contribute to protection from vascular diseases and stroke. Data on social mobility and risk of vascular diseases and of stroke are scarce [5,6,7,8,9,10]. We explored whether aspects of social advancement during lifetime are associated with reduced and aspects of social decline with increased risk of ischemic stroke
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call