Early Socioeconomic Position Research Articles

P1-417 Does life-course socioeconomic position explain colour/race inequalities in the prevalence of self-reported uterine leiomyomas? Evidence from the prÓ-saÚde study, Brazil

IntroductionUSA studies showed that uterine leiomyomas (UL) occur more frequently among black women, but the nature of this association remains largely unexplained. Because black women are disproportionately disadvantaged in social...

P1-32 Testing life course models to investigate the effect of socioeconomic position on crystallised cognitive function in older age, accounting for missing data

ObjectiveTo investigate how lifetime socioeconomic position (SEP) is associated with later-life crystallised cognitive function, accounting for different missing data mechanisms.ParticipantsA nationally representative population sample born in 1946 (MRC National Survey...

Adolescent Alcohol and Tobacco Use and Early Socioeconomic Position: The ALSPAC Birth Cohort

To examine the association between use of alcohol and cigarettes among adolescents and their early socioeconomic background. Members of a longitudinal birth cohort (Avon Longitudinal Study of Parents and Children [ALSPAC], United Kingdom) were invited to attend a personal interview. A total of 5837 children aged 13 years were asked about previous consumption of alcohol and tobacco. Information on parental socioeconomic position, collected from questionnaires from the mother, included both social class and education of the expectant mother and her partner and average household disposable income in early preschool childhood. The impact of missing data was assessed by multiple imputation. Consuming a drink of alcohol in the previous 6 months was linearly associated with higher income levels even when adjusting for other socioeconomic indicators. In contrast, both the risk of binge drinking and recent drinking was lower for children whose mothers had a higher educational level. Smoking tobacco was associated with lower socioeconomic position irrespective of the indicator used. Analyses after imputation of missing data confirmed these associations. Alcohol drinking was more common in young people from higher-income households but less common with higher levels of maternal education. A consistent inverse socioeconomic gradient with tobacco smoking was apparent. These results may reflect how different aspects of socioeconomic position can influence health behavior in opposing directions. Higher income may increase the availability of alcohol in the family, whereas mothers with higher educational attainment might encourage more healthy behaviors in their children, including reduced alcohol use.

Adolescent Alcohol and Tobacco Use and Early Socioeconomic Position: The ALSPAC Birth Cohort

Adolescent Alcohol and Tobacco Use and Early Socioeconomic Position: The ALSPAC Birth Cohort

Life-course socio-economic factors, skin colour and abdominal obesity in adulthood in a Brazilian birth cohort.

ObjectiveObesity is an increasingly prevalent nutritional disorder throughout the world. In particular, abdominal obesity is associated with cardiovascular and metabolic risk. The present study aimed to evaluate the effects of skin colour and life-course socio-economic indicators on waist circumference (WC), hip circumference (HC) and waist:hip ratio (WHR) in young adults.DesignPopulation-based birth cohort study. Individuals born in 1982 in Pelotas (southern Brazil) were visited on a number of occasions from birth to age 23–24 years. A sample of the cohort was sought in 2006 and 972 individuals were located. The analysis was restricted to individuals with complete data available (442 males, 414 females).ResultsIn men, family income at birth and in 2004–5 were positively associated with WC and HC, but not with WHR. Regardless of current income, men born to wealthier families had larger WC and HC as adults. Skin colour was not associated with any of the outcomes. In women, early poverty was associated with smaller HC, and current poverty with larger WC. Poverty at any age thus led to higher WHR. Black women had larger WC and HC than white women, but there were no differences in WHR. All the associations were partially mediated by education and behavioural variables.ConclusionsThe effects of early socio-economic position on WC and HC persist even after adjustment for adult socio-economic position, highlighting the importance of interventions during the first years of life.

Pathways to obesity in a developing population: The Guangzhou Biobank Cohort Study

'Environmental mismatch' may contribute to obesity in rapidly developing societies, because poor early life conditions could increase the risk of obesity in a subsequently more socio-economically developed environment. In a recently developing population (from southern China) we examined the association of life-course socio-economic position (SEP) with obesity. In a cross-sectional study of 9998 adults from the Guangzhou Biobank Cohort Study (phase 2) examined in 2005-06, we used multivariable linear regression to assess the association of SEP at three life stages (proxied by parental possessions, education and longest held occupation) with obesity [body mass index (BMI) and waist-hip ratio (WHR)] in men and women. There was no evidence that socio-economic position trajectory had supra-additive effects on BMI or WHR. Instead in women, higher SEP at any life stage usually contributed to lower BMI and WHR; e.g. women with higher early adult SEP had lower BMI [-0.45; 95% confidence interval (CI) -0.71 to -0.19) and WHR (-0.02; 95% CI -0.02 to -0.012]. In contrast, in men, higher childhood SEP was associated with higher BMI (0.53; 95% CI 0.18 to 0.88) and WHR (0.01; 95% CI 0.003 to 0.02) as was high late adulthood SEP with BMI (0.36; 95% CI 0.07 to 0.64). This study provides little support for environmental mismatch over the life course increasing obesity in this rapidly transitioning southern Chinese population. However, our findings highlight different effects of the epidemiologic transition in men and women, perhaps with pre-adult exposures as a critical window for sex-specific effects.

IQ in late adolescence/early adulthood, risk factors in middle age and later all-cause mortality in men: the Vietnam Experience Study

Objective:To examine the role of potential mediating factors in explaining the IQ–mortality relation.Design, setting and participants:A total of 4316 male former Vietnam-era US army personnel with IQ test results at...

Socio-economic position at three points in life in association with type 2 diabetes and impaired glucose tolerance in middle-aged Swedish men and women

It has been suggested that low socio-economic position (SEP) during childhood and adolescence predicts risk of adult type 2 diabetes. We investigated the associations between type 2 diabetes and childhood SEP (fathers' occupational position), participants' education and adult SEP (participants' occupational position). To determine possible independent associations between early SEP (fathers' occupational position and participants' education) and disease, we adjusted for adult SEP and factors present in adult life associated with type 2 diabetes. This cross-sectional study comprised 3128 men and 4821 women aged 35-56 years. All subjects have gone through a health examination and answered a questionnaire on lifestyle factors. At the health centre, an oral glucose tolerance test was administered and identified 55 men and 52 women with previously undiagnosed type 2 diabetes. Relative risks (RRs) with 95% CIs were calculated in multiple logistic regression analyses. The age-adjusted RRs of type 2 diabetes if having a father with middle occupational position were 2.3 [Confidence interval (CI:1.0-5.1) for women and, 2.0 (CI:0.7-5.6) for men]. Moreover, low education was associated with type 2 diabetes in women, RR = 2.5 (CI:1.2-4.9). Low occupational position in adulthood was associated with type 2 diabetes in women, RR = 2.7 (CI:1.3-5.9) and men, RR = 2.9 (CI:1.5-5.7). The associations between early SEP and type 2 diabetes disappeared after adjustment for adult SEP and factors associated with type 2 diabetes. The association between type 2 diabetes and low SEP during childhood and adolescence in middle-aged Swedish subjects disappeared after adjustment for adult SEP and adult risk factors of diabetes.

Early Socioeconomic Position and Blood Pressure in Childhood and Adulthood

Studies have found an association between low socioeconomic position in childhood and high adult blood pressure. It is unclear whether this association is explained by a pathway directly linking disadvantage to elevated blood pressure in childhood and adolescence, which then tracks into adulthood. We assessed parental socioeconomic position and systolic blood pressure in 1807 children and adolescents ages 3 to 18 years at baseline. Adult systolic blood pressure was measured 21 years later at ages 24 to 39 years. There was strong tracking of blood pressure from childhood to adulthood. Lower parental socioeconomic position was associated with higher blood pressure in childhood, adolescence (P<0.01), and adulthood (P<0.0001), with the mean age- and sex-adjusted systolic pressure differences between the highest and lowest socioeconomic groups varying between 2.9 and 4.3 mm Hg. With adjustment for blood pressure in childhood and adolescence, the regression coefficient between parental socioeconomic position and adult blood pressure attenuated by 32%. A similar level of attenuation (28%) occurred with adjustment for adult body mass index (BMI). With adjustment for both preadult blood pressure and adult BMI, the association between parental socioeconomic position and adult blood pressure was attenuated by 45%. Other factors, including birth weight and BMI in childhood and adolescence, had little impact on the association between parental socioeconomic position and adult blood pressure. These data suggest that early socioeconomic disadvantage influences later blood pressure in part through an effect on blood pressure in early life, which tracks into adulthood, and in part through an effect on BMI.

Socioeconomic Position across the Lifecourse: How Does it Relate to Cognitive Function in Mid-life?

To examine the association between socioeconomic position (SEP) over the lifecourse and cognitive function in middle age. Two alternative models were assessed: the "direct effects model" where temporally distinct measures of SEP have only direct effects on adult cognition, and the "indirect effects" model where the effect of early life SEP are mediated through later life measures of SEP. Data are from the Whitehall II study (N=10,308 at baseline), a longitudinal cohort study of British civil servants, aged between 46 and 68 years at the time of cognitive testing. Structural equation models were used to compare the fit of direct and indirect effects models, and quantify the effects of different measures of SEP on cognition. Childhood SEP, education, and adult SEP were used to model SEP across the lifecourse. Cognitive function was assessed as a latent construct composed of the following: verbal memory, AH 4-I, Mill Hill, phonemic and semantic fluency. The indirect effects model provided a better fit to the data. Childhood SEP had no direct effect on cognitive function but had a substantial "indirect effect," mediated through education and adult SEP. 78.4% of the effect of education in men and 100% in women was indirect. Socioeconomic differences in adult cognition are a result of the socioeconomic trajectory of individuals throughout their lifecourse. Early measures of SEP influence cognition indirectly, through their influence on later measures of SEP.

Association of weight change with ethnicity and life course socioeconomic position among Brazilian civil servants.

Adult weight gain is generally associated with ethnicity of African descent, in addition to low socioeconomic position (SEP), but little information is available from the African diaspora in less-developed countries. We evaluated ethnic differences in adult weight change and the role of life course SEP in those differences. We conducted a cross-sectional analysis of baseline data (1999-2001) from 2594 non-faculty civil servants working at university campuses in Rio de Janeiro (Brazil) and participating in the longitudinal Pró-Saúde Study. Weight and height were measured at study entry whereas ethnicity, markers of SEP, and weight at age 20 were assessed through self-administered questionnaire. Black and mulatto women gained, respectively, an excess of 1.6 kg and 1.2 kg per 10 years of adult life, compared with whites. After adjustment for markers of participants' early and later-life SEP, the estimates of excess weight gain for black and mulatto women decreased by about one-third, but a statistically significant estimate was still observed for black women. Among men, neither unadjusted nor adjusted ethnic gradients in weight gain were relevant. Only among women, black and mulatto ethnicity was associated with increased weight gain, which was partially explained through the association with their lower SEP.