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From cradle to grave: tracking socioeconomic inequalities in mortality in a cohort of 11 868 men and women born in Uppsala, Sweden, 1915–1929
  1. Sol P Juárez1,2,
  2. Anna Goodman1,3,
  3. Ilona Koupil1,4
  1. 1Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Stockholm, Sweden
  2. 2Division of Environmental and Occupational Medicine, Lund University, Lund, Sweden
  3. 3London School of Hygiene and Tropical Medicine (LSHTM), University of London, London, UK
  4. 4Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
  1. Correspondence to Dr Sol P Juárez, Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm 106 91, Sweden; sol.juarez{at}chess.su.se

Abstract

Background Ample evidence has shown that early-life social conditions are associated with mortality later in life. However, little attention has been given to the strength of these effects across specific age intervals from birth to old age. In this paper, we study the effect of the family's socioeconomic position and mother's marital status at birth on all-cause mortality at different age intervals in a Swedish cohort of 11 868 individuals followed across their lifespan.

Methods Using the Uppsala Birth Cohort Multigenerational Study, we fitted Cox regression models to estimate age-varying HRs of all-cause mortality according to mother's marital status and family's socioeconomic position.

Results Mother's marital status and family's socioeconomic position at birth were associated with higher mortality rates throughout life (HR 1.18 (95% CI 1.12 to 1.26) for unmarried mothers; 1.19 (95% CI 1.12 to 1.25) for low socioeconomic position). While the effect of family's socioeconomic position showed little variation across different age groups, the effect of marital status was stronger for infant mortality (HR 1.47 (95% CI 1.23 to 1.76); p=0.04 for heterogeneity). The results remained robust when early life and adult mediator variables were included.

Conclusions Family's socioeconomic position and mother's marital status involve different dimensions of social stratification with independent effects on mortality throughout life. Our findings support the importance of improving early-life conditions in order to enhance healthy ageing.

  • Life course epidemiology
  • Lifecourse / Childhood Circumstances
  • INEQUALITIES
  • MORTALITY

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