Article Text

Download PDFPDF
Adverse socioeconomic position across the lifecourse increases coronary heart disease risk cumulatively: findings from the British women’s heart and health study
  1. Debbie A Lawlor,
  2. Shah Ebrahim,
  3. George Davey Smith
  1. Department of Social Medicine, University of Bristol, UK
  1. Correspondence to:
 Dr D A Lawlor
 Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK;


Objective: To examine the associations of childhood and adult measurements of socioeconomic position with coronary heart disease (CHD) risk.

Methods: Cross sectional and prospective analysis of a cohort of 4286 British women who were aged 60–79 years at baseline. Among these women there were 694 prevalent cases of CHD and 182 new incident cases among 13 217 person years of follow up of women who were free of CHD at baseline.

Results: All measurements of socioeconomic position were associated with increased prevalent and incident CHD in simple age adjusted models. There was a cumulative effect, on prevalent and incident CHD, of socioeconomic position across the lifecourse. This effect was not fully explained by adult CHD risk factors. The adjusted odds ratio of prevalent CHD for each additional adverse (out of 10) lifecourse socioeconomic indicator was 1.11 (95% confidence interval: 1.06, 1.16). The magnitude of the effect of lifecourse socioeconomic position was the same in women who were lifelong non-smokers as in those who had been or were smokers.

Conclusion: Adverse socioeconomic position across the lifecourse increases CHD risk cumulatively and this effect is not fully explained by adult risk factors. Specifically in this cohort of women cigarette smoking does not seem to explain the association between adverse lifecourse socioeconomic position and CHD risk.

  • CHD, coronary heart disease
  • SEP, socioeconomic position
  • HOMA, homoeostasis model assessment
  • coronary heart disease
  • lifecourse epidemiology
  • socioeconomic position

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: we thank the (UK) Department of Health for core support to the British women’s heart and health study. Debbie A Lawlor is funded by a (UK) Department of Health career scientist award. The views expressed in this paper are those of the authors and not necessarily those of any funding body.

  • Conflicts of interest: none.