Background Cardiovascular health develops throughout adult life, with socioeconomic factors such as educational attainment strongly associated with cardiovascular outcomes. However, little is known about the immediate health impacts of socioeconomic exposures during early adulthood. In this study we describe the socioeconomic trajectories of early adulthood (age 16–24 y) in a contemporary population, and assess associations of these trajectories with measures of cardiometabolic health at age 24 y.

Methods ALSPAC cohort participants with data on education and employment between ages 16 y to 24 y (n=7,568) were included. Longitudinal latent class analysis was used to identify classes following different socioeconomic trajectories, based on participation in education and employment across ages 16–24 y, education level attained by 24 y and occupational class of those employed at 23 y. A metabolic health score (MetZscore) was derived based on measures of waist circumference, blood pressure, serum triglycerides, serum high-density lipoprotein cholesterol, and fasting plasma glucose at age 24 y (n=3189). We modelled differences in MetZscore across the socioeconomic trajectory classes, adjusting for sex, childhood socioeconomic position, adolescent health behaviours and adolescent health, imputing missing covariate data and using the 3-step Bolck-Croon-Hagenaars method for latent class analysis with distal outcomes in MPlus.

Results We identified four classes of early adulthood socioeconomic trajectory: (1) Higher Education (41% of the population), (2) Continued Education (9%), (3) Part-Time Employment (21%), and (4) Early Employment (29%). The Higher Education class typically completed higher education and entered intermediate or managerial employment, while the Continued Education class remained in full-time education at age 24 y. The Early Employment class left education and entered employment at around age 18 y, while the Part-Time Employment class showed some higher education but were distinguished by part-time employment throughout early adulthood.

The standardized MetZscore was lowest in the Continued Education class, indicating that this was the healthiest population class. No statistically significant different was seen in MetZscore between the Continued Education class and the Higher Education class (mean difference 0.125, p=0.139). However, the Part-Time Employment class and Early Employment class showed lower metabolic health, compared to the Continued Education class (mean difference 0.193, p=0.046 and mean difference 0.232, p=0.004 respectively), after adjusting for childhood covariates.

Conclusion Identification of socioeconomic trajectories provides a person-centred method for assessment of socioeconomic exposures across the transitional period of early adulthood. Our findings suggest that different socioeconomic trajectories over this period contribute to inequalities in cardiovascular health, which can already be identified through cardiometabolic risk factors at age 24 y.