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Socioeconomic position in early life, birth weight, childhood cognitive function, and adult mortality. A longitudinal study of Danish men born in 1953

Abstract

Objective: To examine the relation between socioeconomic position in early life and mortality in young adulthood, taking birth weight and childhood cognitive function into account.

Design: A longitudinal study with record linkage to the Civil Registration System and Cause of Death Registry. The data were analysed using Cox regression.

Setting: The metropolitan area of Copenhagen, Denmark.

Subjects: 7493 male singletons born in 1953, who completed a questionnaire with various cognitive measures, in school at age 12 years, and for whom birth certificates with data on birth and parental characteristics had been traced manually in 1965. This population was followed up from April 1968 to January 2002 for information on mortality.

Main outcome measures: Mortality from all causes, cardiovascular diseases, and violent deaths.

Results: Men whose fathers were working class or of unknown social class at time of birth had higher mortality rates compared with those whose fathers were high/middle class: hazard ratio 1.39 (95% CI 1.15 to 1.67) and 2.04 (95% CI 1.48 to 2.83) respectively. Birth weight and childhood cognitive function were both related to father’s social class and inversely associated with all cause mortality. The association between father’s social class and mortality attenuated (HRworking class1.30 (1.08 to 1.56); HRunkown class1.81 (1.30 to 2.52)) after control for birth weight and cognitive function. Mortality from cardiovascular diseases and violent deaths was also significantly higher among men with fathers from the lower social classes.

Conclusion: The inverse association between father’s social class at time of birth and early adult mortality remains, however somewhat attenuated, after adjustment for birth weight and cognitive function.

  • birth weight
  • cognitive function
  • mortality
  • social class
  • longitudinal study

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    Author Correction

    Please note that there is an error in the 5th paragraph, next to last line, in the section DATA SOURCES AND VARIABLES
    "ICD10-code K70" should read "100-152, 160-199; ICD10".
    The correct paragraph is shown here:

    From the school questionnaire, we used the information on IQ and creative potential. The IQ test consisted of spatial, arithmetic and verbal sub-tests. In the spatial test, students were asked to choose one out of four alternative three dimensional figures, corresponding to a flat, two dimensional template. In the arithmetic test, students were to determine the logical sequences for a series of six numbers. In the verbal test, students were to identify, out of four alternatives, the antonym of a given word. Each sub-test included 40 problems, with a correct answer counting for one point, resulting in a range of 0�40 points. The overall test ranged from 0 to 120 points, with the highest value reflecting the best score. In the creativity test, students were to come up with a word that was associated somehow with three other rather different words. This test included 25 different word series, and each correct answer counted for 1 point, giving a scoring range of 0 to 25 points. Cause of death was based on official death certificates coded using the 7th Revision of the International Classification of Diseases for the years 1968�1969, the 8th Revision for 1970�1993, and the 10th Revision for 1994�1998. Cause of death was classified into the following selected end points: CVD (ICD7-codes 330�468; ICD8-codes 390�458; ICD10-codes I00-I52,I60-I99; 100-152, 160-199; ICD10); injuries and suicide (ICD7-codes 800�999; ICD8-codes 800�999; ICD10-codes V01-Y99); and other causes (all other codes).

    Footnotes

    • Funding: Danish Heart Association.

    • Conflicts of interest: none declared.

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