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  • Socioeconomic inequalities across life and premature mortality from 1971 to 2016: findings from three British birth cohorts born in 1946, 1958 and 1970

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Socioeconomic inequalities across life and premature mortality from 1971 to 2016: findings from three British birth cohorts born in 1946, 1958 and 1970
  1. Meg E Fluharty1,
  2. Rebecca Hardy2,
  3. George Ploubidis1,
  4. Benedetta Pongiglione3,
  5. David Bann1
  1. 1 UCL Institute of Education, Centre for Longitudinal Studies, London, UK
  2. 2 UCL Institute of Education, Cohort and Longitudinal Studies Enhancement Resources, London, UK
  3. 3 Bocconi University, Centre for Research on Health and Social Care Management, Milano, Italy
  1. Correspondence to Meg E Fluharty, Centre for Longitudinal Studies, University College London, 55-59 Gordon Square, London WC1H 0NU, UK; m.fluharty{at}ucl.ac.uk

Abstract

Introduction Disadvantaged socioeconomic position (SEP) in early and adult life has been repeatedly associated with premature mortality. However, it is unclear whether these inequalities differ across time, nor if they are consistent across different SEP indicators.

Methods British birth cohorts born in 1946, 1958 and 1970 were used, and multiple SEP indicators in early and adult life were examined. Deaths were identified via national statistics or notifications. Cox proportional hazard models were used to estimate associations between ridit scored SEP indicators and all-cause mortality risk—from 26 to 43 years (n=40 784), 26 to 58 years (n=35 431) and 26 to 70 years (n=5353).

Results More disadvantaged SEP was associated with higher mortality risk—magnitudes of association were similar across cohort and each SEP indicator. For example, HRs (95% CI) from 26 to 43 years comparing lowest to highest paternal social class were 2.74 (1.02 to 7.32) in 1946c, 1.66 (1.03 to 2.69) in 1958c, and 1.94 (1.20 to 3.15) in 1970c. Paternal social class, adult social class and housing tenure were each independently associated with mortality risk.

Conclusions Socioeconomic circumstances in early and adult life show persisting associations with premature mortality from 1971 to 2016, reaffirming the need to address socioeconomic factors across life to reduce inequalities in survival to older age.

  • Inequalities
  • Mortality
  • Socio-economic
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/jech-2020-214423

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    Footnotes

    • Twitter Meg Fluharty @MegEliz_.

    • Contributors MEF, RH and DB were involved in the conception and design of the study; MF conducted the analyses and drafted the manuscript; and MEF, RH, GP, BP and DB revised the manuscript and approved for submission.

    • Funding DB is supported by the Economic and Social Research Council (grant number ES/M001660/1) and MF and DB by The Academy of Medical Sciences/Wellcome Trust (‘Springboard Health of the Public in 2040’ award: HOP001/1025). RH is Director of CLOSER, which is funded by the Economic and Social Research Council (award reference: ES/K000357/1). GP is Director of Research of CLS, which is funded by the Economic and Social Research Council (award reference: ES/M001660/1). The funders had no role in study design, data collection and analysis.

    • Competing interests None declared.

    • Patient consent for publication Not required.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.