Relative contribution of early life and adult socioeconomic factors to adult morbidity in the Whitehall II study

Abstract

Study objective-To determine the relative contribution of adult compared with early life socioeconomic status as predictors of morbidity attributable to coronary heart disease (CHD), chronic bronchitis and depression in the Whitehall II study of British civil servants. Design-Prospective observational study with mean 5.3 years (range 3.7-7.6) follow up. Setting-20 civil service departments originally located in London. Participants-6895 male and 3413 female oYce-based civil servants aged 35-55 years at baseline. Outcome measures-New cases at follow up of CHD, chronic bronchitis and depression defined using validated questionnaires. Main results-Employment grade was inversely associated with CHD, chronic bronchitis and depression in men (odds ratio per unit decrease in grade 1.30, 1.44 and 1.20 respectively). Employment grade was strongly related to father's social class. Chronic bronchitis, in women, and depression, in men, were more common among those with fathers of higher social class. When mutual adjustment was made for father's social class, grade at entry to the civil service and current grade, the strongest eVects on adult morbidity were found for current grade. Among participants in whom neither parent had died <70 years of age the inverse association with adult SES was maintained. Conclusions-Adult socioeconomic status was a more important predictor of morbidity attributable to coronary disease, chronic bronchitis and depression than measures of social status earlier in life. In this population, the importance of social circumstances early in life may be in the way they influence employment and social position and thus exposures in adult life. (J Epidemiol Community Health 2001;55:301-307) Circumstances in adulthood are important determinants of adult socioeconomic diVerences in disease. This has been the focus of the Whitehall studies of British civil servants.

Cause-specific hospital admission and mortality among working men: association with socioeconomic circumstances in childhood and adult life, and the mediating role of daily stress

“…While there is evidence that hardship in childhood has long-term consequences for mental health [45,46], the present study failed to provide any evidence of an effect of childhood circumstances on non-organic psychosis and neurosis in adulthood. Perhaps few individuals with psychiatric illness originating in childhood remain in the labour market long enough to be recruited to a study such as the present one.…”

Cause-specific hospital admission and mortality among working men: association with socioeconomic circumstances in childhood and adult life, and the mediating role of daily stress

“…While there is evidence that hardship in childhood has long-term consequences for mental health [45,46], the present study failed to provide any evidence of an effect of childhood circumstances on non-organic psychosis and neurosis in adulthood. Perhaps few individuals with psychiatric illness originating in childhood remain in the labour market long enough to be recruited to a study such as the present one.…”

Pathways from Childhood Economic Conditions to Adult Mortality in a 1953 Stockholm Cohort: The Intermediate Role of Personal Attributes and Socioeconomic Career

“…Also with regard to the role of adult socioeconomic career for mortality risk, our results are in line with previous findings [ 5 , 7 , 9 , 12 , 13 ]. Our results indicate that these findings are robust when taking cognitive ability and social skills into consideration in the analyses.…”

The Impact of Childhood and Adult Educational Attainment and Economic Status on Later Depressive Symptoms and Its Intergenerational Effect

“…Our findings support previous research, suggesting that exposure to economic hardship in early life predicted higher levels of depressive symptoms later [2,4,15,16,25]. In addition, our findings support previous research that childhood SES determines the living conditions in adult life, which gives rise to health inequality [8,34]. In addition to the information, a systematic review of the epidemiological study of the last 19 years supports that the social and economic conditions of poverty such as low income and less education is a consistent positive association with mental health problems [29], and this pattern could also be found through community-based studies of other Asian countries such as Japan, India, Pakistan, Taiwan, and Turkey (listed alphabetically) [4,[49][50][51][52].…”

Cause-specific hospital admission and mortality among working men: association with socioeconomic circumstances in childhood and adult life, and the mediating role of daily stress

“…While there is evidence that hardship in childhood has long-term consequences for mental health [45,46], the present study failed to provide any evidence of an effect of childhood circumstances on non-organic psychosis and neurosis in adulthood. Perhaps few individuals with psychiatric illness originating in childhood remain in the labour market long enough to be recruited to a study such as the present one.…”

Pathways from Childhood Economic Conditions to Adult Mortality in a 1953 Stockholm Cohort: The Intermediate Role of Personal Attributes and Socioeconomic Career

“…Also with regard to the role of adult socioeconomic career for mortality risk, our results are in line with previous findings [ 5 , 7 , 9 , 12 , 13 ]. Our results indicate that these findings are robust when taking cognitive ability and social skills into consideration in the analyses.…”

The Impact of Childhood and Adult Educational Attainment and Economic Status on Later Depressive Symptoms and Its Intergenerational Effect

“…Our findings support previous research, suggesting that exposure to economic hardship in early life predicted higher levels of depressive symptoms later [2,4,15,16,25]. In addition, our findings support previous research that childhood SES determines the living conditions in adult life, which gives rise to health inequality [8,34]. In addition to the information, a systematic review of the epidemiological study of the last 19 years supports that the social and economic conditions of poverty such as low income and less education is a consistent positive association with mental health problems [29], and this pattern could also be found through community-based studies of other Asian countries such as Japan, India, Pakistan, Taiwan, and Turkey (listed alphabetically) [4,[49][50][51][52].…”

Cause-specific hospital admission and mortality among working men: association with socioeconomic circumstances in childhood and adult life, and the mediating role of daily stress

“…While there is evidence that hardship in childhood has long-term consequences for mental health [45,46], the present study failed to provide any evidence of an effect of childhood circumstances on non-organic psychosis and neurosis in adulthood. Perhaps few individuals with psychiatric illness originating in childhood remain in the labour market long enough to be recruited to a study such as the present one.…”

Pathways from Childhood Economic Conditions to Adult Mortality in a 1953 Stockholm Cohort: The Intermediate Role of Personal Attributes and Socioeconomic Career

“…Also with regard to the role of adult socioeconomic career for mortality risk, our results are in line with previous findings [ 5 , 7 , 9 , 12 , 13 ]. Our results indicate that these findings are robust when taking cognitive ability and social skills into consideration in the analyses.…”

The Impact of Childhood and Adult Educational Attainment and Economic Status on Later Depressive Symptoms and Its Intergenerational Effect

“…Our findings support previous research, suggesting that exposure to economic hardship in early life predicted higher levels of depressive symptoms later [2,4,15,16,25]. In addition, our findings support previous research that childhood SES determines the living conditions in adult life, which gives rise to health inequality [8,34]. In addition to the information, a systematic review of the epidemiological study of the last 19 years supports that the social and economic conditions of poverty such as low income and less education is a consistent positive association with mental health problems [29], and this pattern could also be found through community-based studies of other Asian countries such as Japan, India, Pakistan, Taiwan, and Turkey (listed alphabetically) [4,[49][50][51][52].…”