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Do different measures of early life socioeconomic circumstances predict adult mortality? Evidence from the British Whitehall II and French GAZEL studies
  1. Silvia Stringhini1,
  2. Aline Dugravot1,
  3. Mika Kivimaki2,
  4. Martin Shipley2,
  5. Marie Zins1,
  6. Marcel Goldberg1,
  7. Jane E Ferrie2,
  8. Archana Singh-Manoux1,2,3
  1. 1INSERM U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif Cedex, France
  2. 2Department of Epidemiology and Public Health, University College London, London, UK
  3. 3Centre de Gérontologie, Hôpital Ste Périne, AP-HP, France
  1. Correspondence to Silvia Stringhini, INSERM U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Bât 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France; silvia.stringhini{at}inserm.fr

Abstract

Background Father's occupational position, education and height have all been used to examine the effects of adverse early life socioeconomic circumstances on health, but it remains unknown whether they predict mortality equally well.

Methods We used pooled data on 18 393 men and 7060 women from the Whitehall II and GAZEL cohorts to examine associations between early life socioeconomic circumstances and all-cause and cause-specific mortality.

Results During the 20-y follow-up period, 1487 participants died. Education had a monotonic association with all mortality outcomes; the age, sex and cohort-adjusted HR for the lowest versus the highest educational group was 1.45 (95% CI 1.24 to 1.69) for all-cause mortality. There was evidence of a U-shaped association between height and all-cause, cancer and cardiovascular mortality robust to adjustment for the other indicators (HR 1.41, 95% CI 1.03 to 1.93 for those shorter than average and HR 1.36, 95% CI 0.98 to 1.88 for those taller than average for cardiovascular mortality). Greater all-cause and cancer mortality was observed in participants whose father's occupational position was manual rather than non-manual (HR 1.11, 95% CI 1.00 to 1.23 for all-cause mortality), but the risks were attenuated after adjusting for education and height.

Conclusions The association between early life socioeconomic circumstances and mortality depends on the socioeconomic indicator used and the cause of death examined. Height is not a straightforward measure of early life socioeconomic circumstances as taller people do not have a health advantage for all mortality outcomes.

  • Body height
  • early life
  • cohort studies
  • education
  • mortality
  • occupational position

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Footnotes

  • Funding The Whitehall II study has been supported by grants from the British Medical Research Council (MRC); the British Heart Foundation; the British Health and Safety Executive; the British Department of Health; the National Heart, Lung, and Blood Institute (grant HL36310); the National Institute on Aging (grants R01AG013196;R01AG034454); the Agency for Health Care Policy and Research (grant HS06516); and the John D. and Catherine T. MacArthur Foundation Research Networks on Successful Midlife Development and Socioeconomic Status and Health. The GAZEL Cohort study was funded by EDF-GDF and INSERM, and received grants from the Cohortes Santé TGIR Program and the Agence Nationale de la Recherche. AS-M is supported by a ‘European Young Investigator Award’ from the European Science Foundation. JEF is supported by the MRC (Grant # G8802774). MJS is supported by the British Heart Foundation.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University College London Ethics Committee and France's National Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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