Socioeconomic Position Groups Research Articles

Socioeconomic Inequalities in the Prevalence of Nine Established Cardiovascular Risk Factors in a Southern European Population

The evaluation of the gender-specific prevalence of cardiovascular risk factors across socioeconomic position (SEP) categories may unravel mechanisms involved in the development of coronary heart disease. Using a sample of 1704 community dwellers of a Portuguese urban center aged 40 years or older, assessed in 1999–2003, we quantified the age-standardized prevalence of nine established cardiovascular risk factors (diabetes mellitus, hypertension, hypercholesterolemia, smoking, sedentariness, abdominal obesity, poor diet, excessive alcohol intake and depression) across SEP and gender categories. Data on individual education and occupation were collected by questionnaire and used to characterize SEP. The prevalence of seven out of nine well-established risk factors was higher in men. Among women, the prevalence of most of the studied risk factors was higher in lower SEP groups. The main exception was smoking, which increased with education and occupation levels. Among men, socioeconomic gradients were less clear, but lower SEP was associated with a higher prevalence of diabetes, excessive alcohol intake and depression in a graded mode. The historical cultural beliefs and practices captured throughout the lifecourse frame the wide socioeconomic gradients discernible in our study conducted in an unequal European developed population. While men were more exposed to most risk factors, the clearer associations between SEP and risk factors among women support that their adoption of particular healthy behaviors is more dependent on material and symbolic conditions. To fully address the issue of health inequalities, interventions within the health systems should be complemented with population-based policies specifically designed to reduce socioeconomic gradients.

The relationship between high blood glucose and socio-economic position in childhood and adulthood in Korea: findings from the Korean National Health and Nutrition Examination, 2007-09

Unlike the older birth cohort (1943-65), the younger birth cohort (1966-79) has enjoyed much improved standards with dramatic developments in Korea. This article investigated the relationship between socio-economic position (SEP) and risk of high blood glucose, including impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2D) by birth cohort. Of the 11 830 persons, 9792 persons aged 30-64 years participated in National Health and Nutrition Examination Surveys. We categorized four SEP groups based on education level in childhood and adulthood within two birth cohorts. High blood glucose included IFG (n = 2594) and T2D (n = 738). Odds ratio (OR) and 95% confidence interval (CI) were estimated by logistic regression. There was a significantly higher risk of high blood glucose in the younger cohort than in the older cohort. In the younger cohort, the ORs for males of declining SEP and of stable low SEP were OR: 1.50 (95% CI 1.12-2.00) and OR: 1.45 (95% CI 1.08-1.93), respectively. After adjustments, corresponding ORs were 1.47 (95% CI 1.09-1.98) and 1.54 (95% CI 1.14-2.08), respectively. In younger women, the corresponding ORs were 1.68 (95% CI 1.17-2.41) and 1.87 (95% CI 1.30-2.69), respectively; however, obesity attenuated the former relationship. For women in the older cohort, this inverse relationship was found only among those with a stable low SEP (OR 1.31, 95% CI 1.04-1.66); no significance was found after adjustments. There was no significant inverse relationship in the older cohort for men. The relationship between lower SEP and elevated risk of high blood glucose was stronger in the younger birth cohort, and obesity attenuated this inverse relationship in women only.

Trends and inequalities in late-life health and functioning in England

BackgroundRecently, late-life disability rates have declined in several countries of the Organisation for Economic Co-operation, but no national-level trend analysis for England has been available. The authors provide such analysis,...

Association of Socioeconomic Position With Under- and Overnutrition in Pakistan

We assessed the relationship between socioeconomic position (SEP) and under- and overnutrition in Pakistani adults. In 2006, we conducted a cross-sectional study including adult participants ≥20 years of age (n = 3500) residing in district Khairpur in Sindh province of Pakistan. We categorized body mass index (BMI) into <18.5 (underweight), 18.6-22.5 (normal BMI), 23-24.9 (preoverweight), 25-29.9 (overweight), and ≥30 (obese). We assessed the association of SEP based on wealth index measured as quintiles of a linear index derived from household assets and utilities score with categories of BMI through multinomial regression with the use of normal BMI as reference category while accounting for sampling design. After adjusting for age, sex, education level, and occupation, there was no significant association of SEP and underweight, whereas SEP was positively associated with the categories of preoverweight, overweight, and obesity. In comparison with the 1st quintile, those in upper wealth quintiles had significantly greater odds of being preoverweight (4th quintile: adjusted odds ratio [adjOR], 1.47; 95% confidence interval [95% CI], 1.04-2.08; 5th quintile: adjOR, 1.57; 95% CI, 1.12-2.21), overweight (4th quintile; adjOR, 1.97; 95% CI, 1.43-2.72; 5th quintile: adjOR, 2.66; 95% CI, 1.91-3.69) and obese (4th quintile: adjOR, 2.24; 95% CI, 1.37-3.69; 5th quintile: adjOR, 3.65; 95% CI, 2.14-6.22). Shift from under- to overnutrition across SEP groups is occurring in Pakistan. There is a need for re-evaluating national policies and programs to tackle the growing burden of emerging over-nutrition along with rampant under-nutrition.

Health benefits of traffic-related air pollution reduction in different socioeconomic groups: the effect of low-emission zoning in Rome

ObjectivesFew studies have assessed the effects of policies aimed to reduce traffic-related air pollution. The aims of this study were to evaluate the impact, in terms of air quality and...

Green space, health inequality and pregnancy

Green spaces have been suggested to improve physical and mental health and well-being by increasing physical activity, reducing air pollution, noise, and ambient temperature, increasing social contacts and relieving psychophysiological stress. Although these mechanisms also suggest potential beneficial effects of green spaces on pregnancy outcomes, to our knowledge there is no available epidemiological evidence on this impact. We investigated the effects of surrounding greenness and proximity to major green spaces on birth weight and gestational age at delivery and described the effect of socioeconomic position (SEP) on these relationships. This study was based on a cohort of births (N=8246) that occurred in a major university hospital in Barcelona, Spain, during 2001–2005. We determined surrounding greenness from satellite retrievals as the average of Normalized Difference Vegetation Index (NDVI) in a buffer of 100m around each maternal place of residence. To address proximity to major green spaces, a binary variable was used to indicate whether maternal residential address is situated within a buffer of 500m from boundaries of a major green space. For each indicator of green exposure, linear regression models were constructed to estimate change in outcomes adjusted for relevant covariates including individual and area level SEP. None of the indicators of green exposure was associated with birth weight and gestational age. After assessing effect modification based on the level of maternal education, we detected an increase in birth weight (grams) among the lowest education level group (N=164) who had higher surrounding NDVI (Regression coefficient (95% confidence interval (CI) of 436.3 (43.1, 829.5)) or lived close to a major green space (Regression coefficient (95% CI)) of 189.8 (23.9, 355.7)). Our findings suggest a beneficial effect of exposure to green spaces on birth weight only in the lowest SEP group.

Nutrition Knowledge: A Mediator between Socioeconomic Position and Diet Quality in Australian First-Time Mothers

Background Mothers are important role models for eating and are gatekeepers of food in the home. An understanding of maternal dietary behaviors could assist in the promotion of healthy eating for both mother and child. Objective To investigate the independent contribution of socioeconomic position to nutrition knowledge and diet quality, and the contribution of nutrition knowledge to diet quality; and to assess nutrition knowledge as a mediator between socioeconomic position and diet quality. Subjects/setting Subjects included first-time Australian mothers residing in Melbourne, Australia (n=527). Design Cross-sectional data from the Melbourne InFANT (Infant Feeding, Activity, and Nutrition Trial) Program. Methods A self-completed validated food-frequency questionnaire recorded dietary intake during the past year and a diet quality score was developed. Maternal education was used to classify socioeconomic position. Regression analyses were undertaken to assess associations between socioeconomic position and nutrition knowledge score; socioeconomic position and diet score; and nutrition knowledge score and diet score. Baron and Kenny's approach to mediation analyses was used to assess nutrition knowledge as a mediator. Results Overall maternal diet quality was poor, with average diet quality scores of 52.4, 52.9, and 57.1 out of a possible 80, in the low, medium, and high socioeconomic groups, respectively. Maternal diet quality was significantly better in mothers of high socioeconomic position as compared with the low socioeconomic position group ( P<0.001). Overall nutrition knowledge was found to be quite high, with mean nutrition knowledge scores of 12.5, 12.7, and 13.7 out of a possible 17, in the low, medium, and high socioeconomic groups, respectively. Maternal nutrition knowledge was found to partly mediate the association between socioeconomic position and maternal diet quality. Conclusions Poor maternal dietary quality may have implications for both mother and child, and socioeconomic position and nutrition knowledge are likely to be important. Effective interventions to support mothers to achieve healthy diets for themselves and their families are needed.

Socioeconomic and ethnic differences in use of lipid-lowering drugs after deregulation of simvastatin in the UK: The Whitehall II prospective cohort study

BackgroundWe examined socioeconomic and ethnic differences in use of lipid-lowering drugs after deregulation of simvastatin in the UK for adults with moderate or high risk of coronary heart disease. Methods3631 participants in the Whitehall II cohort study (mean age 62.7years, 91% white) were informed of their risk of coronary heart disease, based on Framingham score, before deregulation (2002–2004). The use of prescribed lipid-lowering drugs and use of over-the-counter simvastatin were analysed as outcome variables, after deregulation (2005–2007). Results2451 participants were at high risk and 1180 at moderate risk. 20% moderate-risk and 44% high-risk participants reported using prescribed lipid-lowering drugs although no over-the-counter simvastatin was used. Prescribing rates did not differ between employment grades (an index of socioeconomic position), but was higher among South Asian high-risk compared with White high-risk participants (odds ratio 1.64, 95% CI 1.21–2.23). Of the high-risk participants, 44% recalled their increased coronary heart disease risk. South Asian high-risk participants were less likely to recall than White high-risk participants (odds ratio 0.65, 95% CI 0.46–0.93). Furthermore, high risk participants with middle (odds ratio 0.74, 95% CI 0.61–0.89) and low (odds ratio 0.52, 95% CI 0.37–0.74) employment grades were less likely to recall than those with high grades. ConclusionSocioeconomic and ethnic differences in reported use of lipid-lowering drugs were small, but the use of these drugs in general was much lower than recommended and the participants did not utilise over-the-counter statins. Ethnic minorities and lower socioeconomic position groups were less likely to be aware of their increased coronary risk.

Influences on Preschool Children's Physical Activity

This study explored mothers' perceptions of influences on preschoolers' physical activity. Six semistructured focus groups with 23 mothers were conducted across a range of socioeconomic position locations. Mothers identified 4 key areas of influence: child fundamentals (eg, sex, personality), parent power (eg, rules, support), people to share with (eg, peers, adults), and places and things (eg, physical environments, toys). No substantial differences in themes were identified among socioeconomic position groups. Influences on preschoolers' physical activity are multidimensional, multifactorial, and support the use of ecological models to conceptualize and understand the influencing factors. Associations among factors influencing preschoolers' physical activity should be further investigated through quantitative research.

Socioeconomic position and cognitive decline using data from two waves: what is the role of the wave 1 cognitive measure?

Background:Analysis of change in health status using data from two waves can be examined either adjusted or unadjusted for baseline health status. The effect of socioeconomic position (SEP) on cognitive...

Socioeconomic Position and Graft Failure in Pediatric Heart Transplant Recipients

Socioeconomic (SE) position may affect availability of resources, health-related behavior, and outcomes. We assessed whether patient SE position, determined for the block group of patient residence (average population 1000, smallest census unit with SE data), is associated with graft failure in pediatric heart transplant recipients. We used the US Census 2000 database to derive a composite SE score for the block group of residence for all patients who underwent their first heart transplant at Children's Hospital Boston between 1991 and 2005 (n=135). Cox proportional hazards models were used to determine the risk of graft failure (death or retransplant) in the lowest tertile SE group (low SE group) compared with the remaining 2 of 3 patients (controls). The 2 groups were similar with respect to age, gender, diagnosis, and year of transplant. White race was less frequent in low SE group (64% versus 90%, P=0.001). Graft failure occurred in 46 transplant recipients (40 deaths, 6 retransplant). Low SE group (hazard ratio 2.4, 95% CI 1.3 to 4.3) and nonwhite race (hazard ratio 2.7, 95% CI 1.4 to 5.2) were both associated with higher risk of graft failure. In a multivariable model controlling for diagnosis and pretransplant support, race, and low SE position (hazard ratio 2.0, 95% CI 1.0 to 3.7, P=0.04) remained associated with graft failure. Low SE position group had a higher incidence rate of graft rejection and was at a higher risk of late rejection. Low SE position may be an independent risk factor for graft failure in pediatric heart transplant recipients.

Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century

The aim of this study was to determine and quantify socioeconomic position (SEP) inequalities in diabetes mellitus in different areas of Europe, at the turn of the century, for men and women. We analysed data from ten representative national health surveys and 13 mortality registers. For national health surveys the dependent variable was the presence of diabetes by self-report and for mortality registers it was death from diabetes. Educational level (SEP), age and sex were independent variables, and age-adjusted prevalence ratios (PRs) and risk ratios (RRs) were calculated. In the overall study population, low SEP was related to a higher prevalence of diabetes, for example men who attained a level of education equivalent to lower secondary school or less had a PR of 1.6 (95% CI 1.4-1.9) compared with those who attained tertiary level education, whereas the corresponding value in women was 2.2 (95% CI 1.9-2.7). Moreover, in all countries, having a disadvantaged SEP is related to a higher rate of mortality from diabetes and a linear relationship is observed. Eastern European countries have higher relative inequalities in mortality by SEP. According to our data, the RR of dying from diabetes for women with low a SEP is 3.4 (95% CI 2.6-4.6), while in men it is 2.0 (95% CI 1.7-2.4). In Europe, educational attainment and diabetes are inversely related, in terms of both morbidity and mortality rates. This underlines the importance of targeting interventions towards low SEP groups. Access and use of healthcare services by people with diabetes also need to be improved.

The association between socioeconomic position, use of revascularization procedures and five-year survival after recovery from acute myocardial infarction

BackgroundPatients living under better socioeconomic circumstances often receive more active treatments after an acute myocardial infarction (AMI) compared to less affluent patients. However, most previous studies were performed in countries with less comprehensive coverage for medical services. In this Swedish nation-wide longitudinal study we wanted to evaluate long-term survival after AMI in relation to socioeconomic position (SEP) and use of revascularization.MethodsFrom the Swedish Myocardial Infarction Register we identified all 45 to 84-year-old patients (16,041 women and 30,366 men) alive 28 days after their first AMI during the period 1993 to 1996. We obtained detailed information on the use of revascularization, cumulative household income from the 1975 and 1990 censuses and 5-year survival after the AMI.ResultsPatients with the highest cumulative income (adding the values of the quartile categories of income in 1975 and 1990) underwent a revascularization procedure within one month after their first AMI two to three times as often as patients with the lowest cumulative income and had half the risk of death within five years. The socioeconomic differences in the use of revascularization procedures could not be explained by differences in co-morbidity or type of hospital at first admission. Patients who underwent revascularization showed a similar lowered mortality risk in the different income groups, while there were strong socioeconomic differences in long-term mortality among patients who did not undergo revascularization.ConclusionThis nationwide Swedish study showed that patients with high income had a better long-term survival after recovery from their AMI compared to patients with low income. Furthermore, even though the use of revascularization procedures is beneficial, low SEP groups receive it less often than high SEP groups.

Barriers and Facilitators to Home Computer and Internet Use Among Urban Novice Computer Users of Low Socioeconomic Position

Background Despite the increasing penetration of the Internet and amount of online health information, there are significant barriers that limit its widespread adoption as a source of health information. One is the “digital divide,” with people of higher socioeconomic position (SEP) demonstrating greater access and usage compared to those from lower SEP groups. However, as the access gap narrows over time and more people use the Internet, a shift in research needs to occur to explore how one might improve Internet use as well as website design for a range of audiences. This is particularly important in the case of novice users who may not have the technical skills, experience, or social connections that could help them search for health information using the Internet. The focus of our research is to investigate the challenges in the implementation of a project to improve health information seeking among low SEP groups. The goal of the project is not to promote health information seeking as much as to understand the barriers and facilitators to computer and Internet use, beyond access, among members of lower SEP groups in an urban setting.Objective The purpose was to qualitatively describe participants’ self-identified barriers and facilitators to computer and Internet use during a 1-year pilot study as well as the challenges encountered by the research team in the delivery of the intervention.Methods Between August and November 2005, 12 low-SEP urban individuals with no or limited computer and Internet experience were recruited through a snowball sampling. Each participant received a free computer system, broadband Internet access, monthly computer training courses, and technical support for 1 year as the intervention condition. Upon completion of the study, participants were offered the opportunity to complete an in-depth semistructured interview. Interviews were approximately 1 hour in length and were conducted by the project director. The interviews were held in the participants’ homes and were tape recorded for accuracy. Nine of the 12 study participants completed the semistructured interviews. Members of the research team conducted a qualitative analysis based on the transcripts from the nine interviews using the crystallization/immersion method.Results Nine of the 12 participants completed the in-depth interview (75% overall response rate), with three men and six women agreeing to be interviewed. Major barriers to Internet use that were mentioned included time constraints and family conflict over computer usage. The monthly training classes and technical assistance components of the intervention surfaced as the most important facilitators to computer and Internet use. The concept of received social support from other study members, such as assistance with computer-related questions, also emerged as an important facilitator to overall computer usage.Conclusions This pilot study offers important insights into the self-identified barriers and facilitators in computer and Internet use among urban low-SEP novice users as well as the challenges faced by the research team in implementing the intervention.

SOCIOECONOMIC POSITION, CLUSTERING OF RISK FACTORS, AND THE RISK OF MYOCARDIAL INFARCTION

We read with great interest the article by Kivimaki et al. on socioeconomic position (SEP), clustering of behavioral risk factors, and the risk of coronary heart disease published in the May 2007 issue of the Journal.1 To contribute to the sparse discussion on SEP and risk factor clustering, we propose the use of the wording of between-group clustering to describe the clustering of risk factors in different socioeconomic groups, as seen in Table 1 ▶ of the cited paper, and within-group clustering to describe the clustering of risk factors within a socioeconomic group, taking the group-specific prevalence of risk factors into account, as seen in Table 2 ▶ in that same article. (There may be a possible error in the table: Men, 3–4 rf, low SEP, Exp. No., reads 283, should probably read 213). We acknowledge the large study sample and the clarity of the article. TABLE 1— Risk of Myocardial Infarction by Socioeconomic Position (SEP) and Exposure to Increasing Number of Risk Factors: Stockholm Heart Epidemiology Program, Stockholm, Sweden, 1992–1994 TABLE 2— Age-Adjusted Observed and Expected Prevalence of Exposure to Increasing Number of Risk Factors and Observed-to-Expected Comparison, by Socioeconomic Position (Manual or Nonmanual Worker), in Childhood and Adulthood Among the Male Control Group: Stockholm ... We analyzed trajectories of SEP, clustering of 7 risk factors (diabetes, hypertension, low life control, low social network, obesity, physical inactivity, and smoking) and risk of acute myocardial infarction in the Stockholm Heart Epidemiology Program, a population-based case-control study. Accumulation of SEP over the entire life course, risk factor exposure, and acute myocardial infarction incidence have previously been analyzed in the same data.2 Our results confirm the findings by Kivimaki et al., with a larger risk factor burden on lower SEP trajectories, a greater than expected prevalence of null- and multiex-posed individuals in most trajectories of SEP, and an increased risk of acute myocardial infarction with exposure to an increasing number of risk factors. There was also no systematic socioeconomic difference in risk of acute myocardial infarction in the group unexposed to all 7 risk factors (Tables 1 ▶ and 2 ▶). The larger prevalence of multiexposed individuals among low SEP groups and the larger prevalence of null-exposed individuals in higher SEP trajectories does not seem to be the effect of differential individual clustering among different SEPs, because the within-group clustering is similar in all SEPs. Rather, it seems to be the effect of risk factor accumulation correlated to the socioeconomic career on the group level (i.e., between-group clustering). This is important for future attempts to reveal this part of the etiology of health inequalities, because it leads us to look for determinants of risk factor clustering that are distributed differentially between socioeconomic groups.

Active versus passive transportation to school–differences in screen time, socio-economic position and perceived environmental characteristics in adolescent girls

Objective: The aims of this study were (1) to assess the relationships between transport to and from school (active vs. passive), sedentary behaviours, measures of socio-economic position and perceived environmental variables, and (2) to determine which, if any, variables were predictors of active transportation.Methods: The sample comprised 705 girls with mean age of 14.7 (SD = 1.6) years old. Questionnaires were used to describe travel mode to school and to estimate weekly television and computer use (screen time). Girls were assigned to active transportation (AT) or passive transportation (PT) groups depending on whether they walked or bicycled (AT) to and from school or travelled by car or bus (PT). Screen time was determined by the number of hours they reported watching television and using computers in the week preceding the examination, including weekends. Socio-economic position was established by parental occupation and educational level. A questionnaire assessed Perceived Neighbourhood Environments.Results: No statistically significant differences were seen for screen time between travel groups. Occupational status of both mother (r = −0.17) and father (r = −0.15) and father's educational level (r = −0.10) were significantly and negatively associated with AT, while street connectivity (r = 0.10) was positively and significantly associated with AT. Logistic regression analysis showed that the likelihood of active commuting decreased by around 50% with increasing father's occupation (odds ratio (OR) = 0.51; p ≤ 0.05) and father's education (OR = 0.52; p ≤ 0.05) from low to middle socio-economic position groups. Further, the data showed that girls who agreed that ‘there are many four-way intersections in my neighbourhood’ were more likely to be active (OR = 1.63; p ≤ 0.05).Conclusion: The data of this study showed that lower socio-economic position is associated with active commuting to school and that street connectivity is a predictor of active transportation in adolescent girls.

Trends in risk factors for lifestyle-related diseases by socioeconomic position in Geneva, Switzerland, 1993-2000: health inequalities persist.

We report on trends in risk factors for lifestyle-related diseases among socioeconomic position (SEP) groups. We continuously surveyed the adult population of Geneva, Switzerland, for 8 years (1993-2000) with independent, cross-sectional surveys of representative samples (4207 men and 3987 women aged 35-74 years). Age-adjusted linear regression slopes estimated annual risk factor trends. Interaction terms were tested for trend differences between SEP groups. Overall, low-SEP persons had the worst risk factor profiles. Eight-year trends indicate that (1) number of pack-years smoked decreased by half a pack-year among high-SEP female current smokers only; (2) obesity prevalence more than doubled from 5% to 11% among high-SEP men only; (3) systolic and diastolic blood pressures decreased similarly in all SEP groups; (4) unsaturated-to-saturated dietary fat ratio declined in the low-SEP group only; and (5) physical inactivity and current/former cigarette smoking prevalences remained unchanged in all SEP groups. Smoking, obesity, high blood pressure, and physical inactivity are more prevalent among low-SEP persons. Most socioeconomic risk factor differences remained stable in the 1990s. Thus, social inequalities in chronic disease morbidity and mortality will persist in the next decades.

Ethnicity, socio-economic position and gender—do they affect reported health—care seeking behaviour?

While the pursuit of equity of access to health care is a central objective of many health care systems, there is evidence that patients of ethnic minority descent, in lower socio-economic position (SEP) or of female gender are less likely than Whites, more affluent groups or men, respectively, to access secondary and tertiary medical care. However, it is unclear at which point in the chain of events leading from perception of need through attendance at primary/emergency care, to referral and receipt of secondary care, this inequality occurs. This study examined the influence of ethnicity, socio-economic position and gender on an individual's perception of the need and urgency for seeking health care. A random sample was selected from two large city General Practices in the UK who were sent postal questionnaires which included two clinical vignettes describing characters experiencing chest pain and discovering a lump in the armpit. The main outcome measure was response to the ‘chest pain’ and ‘lump’ vignettes in terms of immediate health care utilisation. The questionnaire survey ( n=1350, response rate 66%) indicated that Black respondents, respondents from lower socio-economic groups and women were at least as likely to report immediate health care seeking in response to the clinical vignettes than White respondents, those from higher socio-economic groups or men. This finding was consistent across all scenarios after adjustment for interpretation of the vignette, access to health services and attitudes to health and health care. For example, those in the lowest SEP group were almost 60% more likely to report immediate care seeking in response to the lump vignette (OR 1.59, 95% CI 1.08–2.33) compared to those in the highest SEP group; and Black respondents 40% more likely (OR 1.41, 95% CI 0.92–2.17). This study suggests inequalities in access to health care by ethnicity, socio-economic position and gender are not related to patients in these groups failing to self-refer to primary or accident and emergency care, barriers must therefore occur at the level of health care provision.

Intimations of quality: antemortem and post-mortem diagnoses

<h3>Background</h3> Alcohol use is the third most important global-health risk factor and a main contributor to health inequalities. Previous research on social determinants of alcohol-related disorders has delivered inconsistent results. We aimed to investigate whether socioeconomic position (SEP) in childhood predicts alcohol-related disorders in young adulthood in a Swedish national cohort. <h3>Methods</h3> We studied a register-based national cohort of Swedish citizens born during 1973–1984 (N=948 518) and followed them up to 2009 from age 15. Childhood SEP was defined by a six-category socioeconomic index from the Censuses of 1985 and 1990. HRs of alcohol-related disorders, as indicated by register entries on alcohol-related death and alcohol-related medical care, were analysed in Cox regression models with adjustment for sociodemographic variables and indicators of parental morbidity and criminality. <h3>Results</h3> Low childhood SEP was associated with alcohol-related disorders later in life among both men and women in a stepwise manner. Growing up in a household with the lowest SEP was associated with risk for alcohol-related disorders of HR: 2.24 (95% CI 2.08 to 2.42) after adjustment for sociodemographic variables, compared with the highest SEP group. Adjusting the analysis for parental psychosocial problems attenuated the association to HR 1.87 (95% CI 1.73 to 2.01). <h3>Conclusions</h3> The study demonstrates that low SEP in childhood predicts alcohol-related disorders in young adulthood. Alcohol abuse needs to be addressed in policies to bridge the gap of health inequalities.