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The effect of early-life and adult socioeconomic position on development of lifestyle-related diseases.
Ejlskov, Linda; Bøggild, Henrik; Hansen, Claus D; Wulff, Jesper; Hansen, Steen M; Starkopf, Liis; Lange, Theis; Gerds, Thomas; Torp-Pedersen, Christian.
Afiliação
  • Ejlskov L; Unit for Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
  • Bøggild H; Public Health and Epidemiology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
  • Hansen CD; Unit for Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
  • Wulff J; Public Health and Epidemiology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
  • Hansen SM; Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark.
  • Starkopf L; Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.
  • Lange T; Unit for Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
  • Gerds T; Public Health and Epidemiology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
  • Torp-Pedersen C; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
Eur J Public Health ; 29(3): 562-567, 2019 06 01.
Article em En | MEDLINE | ID: mdl-30445458
ABSTRACT

BACKGROUND:

Early-life socioeconomic position (SEP) is associated with lifestyle-related diseases in adulthood. However, evidence is lacking on the extent to which adult SEP mediates this association.

METHODS:

Time to either chronic obstructive pulmonary disease (COPD), cardiovascular disease or diabetes were assessed in the Danish population born between 1961 and 1971 (n = 793 674) from age 30 until 2015. Early-life position was assessed in 1981 (by parental) and again at age 30 (own) by four markers; income, occupation, education-divided into high, middle, low-and a combined score for all markers. Using a counterfactual approach, we estimated the total effect of early-life position on disease onset and the degree to which adult position mediated this effect.

RESULTS:

Results of the time-to-event analysis showed a gradient of all early-life markers on the risk of developing all lifestyle-related diseases. Notably, comparing those in the lowest to the highest educational position, the hazard of COPD was 130% higher for women [hazard ratio = 2.30(95% confidence interval = 2.20-2.41)] and 114% higher for men [2.14 (2.05-2.25)]. About 67%(63-70%) of the effect of educational position was mediated through adult position for COPD, 55% for cardiovascular disease and 50% for diabetes. For the combined score 44, 29 and 33%, respectively, was mediated.

CONCLUSION:

About one-tenth to two-thirds of the effect of early-life position is mediated by the position attained in adulthood. The degree mediated depend on the outcome investigated, gender and the social position marker used indicating that alternative pathways may play a key role in developing effective policies targeting early-life behaviours.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Classe Social / Doenças Cardiovasculares / Doença Pulmonar Obstrutiva Crônica / Diabetes Mellitus Tipo 2 / Estilo de Vida Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País/Região como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Classe Social / Doenças Cardiovasculares / Doença Pulmonar Obstrutiva Crônica / Diabetes Mellitus Tipo 2 / Estilo de Vida Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País/Região como assunto: Europa Idioma: En Ano de publicação: 2019 Tipo de documento: Article