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. 1999 Jul;89(7):1059–1065. doi: 10.2105/ajph.89.7.1059

The duration and timing of exposure: effects of socioeconomic environment on adult health.

C Power 1, O Manor 1, S Matthews 1
PMCID: PMC1508840  PMID: 10394316

Abstract

OBJECTIVES: This study investigated timing and duration effects of socioeconomic status (SES) on self-rated health at 33 years of age and established whether health risks are modified by changing SES and whether cumulative SES operates through education. METHODS: Data were from the 1958 British birth cohort. Occupational class at birth and at 16, 23, and 33 years of age was used to generate a lifetime SES score. RESULTS: At 33 years of age, 12% of men and women reported poor health. SES at birth and at 16, 23, and 33 years of age was significantly associated with poor health: all ages except 16 years in men made an additional contribution to the prediction of poor health. No large differences in effect sizes emerged, suggesting that timing was not a major factor. Odds of poor health increased by 15% (men) and 18% (women) with a 1-unit increase in the lifetime SES score. Strong effects of lifetime SES persisted after adjustment for education level. CONCLUSIONS: SES from birth to 33 years of age had a cumulative effect on poor health in early adulthood. This highlights the importance of duration of exposure to socioeconomic conditions for adult health.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appels A., Bosma H., Grabauskas V., Gostautas A., Sturmans F. Self-rated health and mortality in a Lithuanian and a Dutch population. Soc Sci Med. 1996 Mar;42(5):681–689. doi: 10.1016/0277-9536(95)00195-6. [DOI] [PubMed] [Google Scholar]
  2. Bartley M., Power C., Blane D., Smith G. D., Shipley M. Birth weight and later socioeconomic disadvantage: evidence from the 1958 British cohort study. BMJ. 1994 Dec 3;309(6967):1475–1478. doi: 10.1136/bmj.309.6967.1475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Blane D., Hart C. L., Smith G. D., Gillis C. R., Hole D. J., Hawthorne V. M. Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood. BMJ. 1996 Dec 7;313(7070):1434–1438. doi: 10.1136/bmj.313.7070.1434. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brunner E., Davey Smith G., Marmot M., Canner R., Beksinska M., O'Brien J. Childhood social circumstances and psychosocial and behavioural factors as determinants of plasma fibrinogen. Lancet. 1996 Apr 13;347(9007):1008–1013. doi: 10.1016/s0140-6736(96)90147-6. [DOI] [PubMed] [Google Scholar]
  5. Davey Smith G., Hart C., Hole D., MacKinnon P., Gillis C., Watt G., Blane D., Hawthorne V. Education and occupational social class: which is the more important indicator of mortality risk? J Epidemiol Community Health. 1998 Mar;52(3):153–160. doi: 10.1136/jech.52.3.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Duncan G. J., Brooks-Gunn J., Klebanov P. K. Economic deprivation and early childhood development. Child Dev. 1994 Apr;65(2 Spec No):296–318. [PubMed] [Google Scholar]
  7. Elo I. T., Preston S. H. Effects of early-life conditions on adult mortality: a review. Popul Index. 1992 Summer;58(2):186–212. [PubMed] [Google Scholar]
  8. Forsdahl A. Are poor living conditions in childhood and adolescence an important risk factor for arteriosclerotic heart disease? Br J Prev Soc Med. 1977 Jun;31(2):91–95. doi: 10.1136/jech.31.2.91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gliksman M. D., Kawachi I., Hunter D., Colditz G. A., Manson J. E., Stampfer M. J., Speizer F. E., Willett W. C., Hennekens C. H. Childhood socioeconomic status and risk of cardiovascular disease in middle aged US women: a prospective study. J Epidemiol Community Health. 1995 Feb;49(1):10–15. doi: 10.1136/jech.49.1.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Idler E. L., Angel R. J. Self-rated health and mortality in the NHANES-I Epidemiologic Follow-up Study. Am J Public Health. 1990 Apr;80(4):446–452. doi: 10.2105/ajph.80.4.446. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kaplan G. A., Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol. 1983 Mar;117(3):292–304. doi: 10.1093/oxfordjournals.aje.a113541. [DOI] [PubMed] [Google Scholar]
  12. Kaplan G. A., Salonen J. T. Socioeconomic conditions in childhood and ischaemic heart disease during middle age. BMJ. 1990 Nov 17;301(6761):1121–1123. doi: 10.1136/bmj.301.6761.1121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lynch J. W., Kaplan G. A., Cohen R. D., Kauhanen J., Wilson T. W., Smith N. L., Salonen J. T. Childhood and adult socioeconomic status as predictors of mortality in Finland. Lancet. 1994 Feb 26;343(8896):524–527. doi: 10.1016/s0140-6736(94)91468-0. [DOI] [PubMed] [Google Scholar]
  14. Lynch J. W., Kaplan G. A., Shema S. J. Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. N Engl J Med. 1997 Dec 25;337(26):1889–1895. doi: 10.1056/NEJM199712253372606. [DOI] [PubMed] [Google Scholar]
  15. Mackenbach J. P. Socio-economic health differences in The Netherlands: a review of recent empirical findings. Soc Sci Med. 1992 Feb;34(3):213–226. doi: 10.1016/0277-9536(92)90264-q. [DOI] [PubMed] [Google Scholar]
  16. Manor O., Matthews S., Power C. Comparing measures of health inequality. Soc Sci Med. 1997 Sep;45(5):761–771. doi: 10.1016/s0277-9536(96)00412-1. [DOI] [PubMed] [Google Scholar]
  17. McDonough P., Duncan G. J., Williams D., House J. Income dynamics and adult mortality in the United States, 1972 through 1989. Am J Public Health. 1997 Sep;87(9):1476–1483. doi: 10.2105/ajph.87.9.1476. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Miilunpalo S., Vuori I., Oja P., Pasanen M., Urponen H. Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J Clin Epidemiol. 1997 May;50(5):517–528. doi: 10.1016/s0895-4356(97)00045-0. [DOI] [PubMed] [Google Scholar]
  19. Mittlböck M., Schemper M. Explained variation for logistic regression. Stat Med. 1996 Oct 15;15(19):1987–1997. doi: 10.1002/(SICI)1097-0258(19961015)15:19<1987::AID-SIM318>3.0.CO;2-9. [DOI] [PubMed] [Google Scholar]
  20. Møller L., Kristensen T. S., Hollnagel H. Self rated health as a predictor of coronary heart disease in Copenhagen, Denmark. J Epidemiol Community Health. 1996 Aug;50(4):423–428. doi: 10.1136/jech.50.4.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Nyström Peck A. M. Childhood environment, intergenerational mobility, and adult health--evidence from Swedish data. J Epidemiol Community Health. 1992 Feb;46(1):71–74. doi: 10.1136/jech.46.1.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Power C., Matthews S., Manor O. Inequalities in self rated health in the 1958 birth cohort: lifetime social circumstances or social mobility? BMJ. 1996 Aug 24;313(7055):449–453. doi: 10.1136/bmj.313.7055.449. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Power C., Matthews S., Manor O. Inequalities in self-rated health: explanations from different stages of life. Lancet. 1998 Apr 4;351(9108):1009–1014. doi: 10.1016/S0140-6736(97)11082-0. [DOI] [PubMed] [Google Scholar]
  24. Power C., Matthews S. Origins of health inequalities in a national population sample. Lancet. 1997 Nov 29;350(9091):1584–1589. doi: 10.1016/S0140-6736(97)07474-6. [DOI] [PubMed] [Google Scholar]
  25. Rahkonen O., Arber S., Lahelma E. Health inequalities in early adulthood: a comparison of young men and women in Britain and Finland. Soc Sci Med. 1995 Jul;41(2):163–171. doi: 10.1016/0277-9536(94)00320-s. [DOI] [PubMed] [Google Scholar]
  26. Schwartz J. E., Friedman H. S., Tucker J. S., Tomlinson-Keasey C., Wingard D. L., Criqui M. H. Sociodemographic and psychosocial factors in childhood as predictors of adult mortality. Am J Public Health. 1995 Sep;85(9):1237–1245. doi: 10.2105/ajph.85.9.1237. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Smith G. D., Hart C., Blane D., Gillis C., Hawthorne V. Lifetime socioeconomic position and mortality: prospective observational study. BMJ. 1997 Feb 22;314(7080):547–552. doi: 10.1136/bmj.314.7080.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Vågerö D., Leon D. Effect of social class in childhood and adulthood on adult mortality. Lancet. 1994 May 14;343(8907):1224–1225. doi: 10.1016/s0140-6736(94)92432-5. [DOI] [PubMed] [Google Scholar]
  29. Wadsworth M. E., Cripps H. A., Midwinter R. E., Colley J. R. Blood pressure in a national birth cohort at the age of 36 related to social and familial factors, smoking, and body mass. Br Med J (Clin Res Ed) 1985 Nov 30;291(6508):1534–1538. doi: 10.1136/bmj.291.6508.1534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wannamethee G., Shaper A. G. Self-assessment of health status and mortality in middle-aged British men. Int J Epidemiol. 1991 Mar;20(1):239–245. doi: 10.1093/ije/20.1.239. [DOI] [PubMed] [Google Scholar]
  31. Wannamethee S. G., Whincup P. H., Shaper G., Walker M. Influence of fathers' social class on cardiovascular disease in middle-aged men. Lancet. 1996 Nov 9;348(9037):1259–1263. doi: 10.1016/S0140-6736(96)02465-8. [DOI] [PubMed] [Google Scholar]
  32. Wax Y. Collinearity diagnosis for a relative risk regression analysis: an application to assessment of diet-cancer relationship in epidemiological studies. Stat Med. 1992 Jul;11(10):1273–1287. doi: 10.1002/sim.4780111003. [DOI] [PubMed] [Google Scholar]
  33. Winkleby M. A., Jatulis D. E., Frank E., Fortmann S. P. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992 Jun;82(6):816–820. doi: 10.2105/ajph.82.6.816. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Wolfson M., Rowe G., Gentleman J. F., Tomiak M. Career earnings and death: a longitudinal analysis of older Canadian men. J Gerontol. 1993 Jul;48(4):S167–S179. doi: 10.1093/geronj/48.4.s167. [DOI] [PubMed] [Google Scholar]

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