Am J Epidemiol 2004; 159:481-490.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Childhood and Adult Socioeconomic Conditions and 31-Year Mortality Risk in Women
1 Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI.
2 School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia.
3 Center for Biostatistics in AIDS Research, School of Public Health, Harvard University, Boston, MA.
4 Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI.
Links between low socioeconomic position and poor health are well established. Most previous research, however, has focused on middle-aged males and has relied on limited socioeconomic data, usually measured at one point over the life course. This paper examines all-cause, cardiovascular, and noncardiovascular mortality in women in relation to socioeconomic position at different stages of the life course. Information was collected in 1965, 1974, 1983, and 1994 and included recalled father’s occupation and education as a measure of childhood socioeconomic position and the respondent’s household income, education and occupation, and spouse’s occupation from a sample of 3,087 women participating in the Alameda County Study. Cox regression models were used to estimate hazard ratios for risk of death. Lower childhood socioeconomic position was associated with an increased mortality due to cardiovascular disease (hazard ratio (HR) = 1.29, 95% confidence interval (CI): 1.09, 1.54) but was unrelated to death due to other causes (HR = 0.97, 95% CI: 0.82, 1.15). Overall mortality was higher among women reporting the lowest level of education (HR = 1.17, 95% CI: 0.99, 1.39), but education was most strongly related to noncardiovascular disease-related deaths (HR = 1.41, 95% CI: 1.10, 1.81). Low household income was also associated with higher mortality, for both cardiovascular disease-related (HR = 1.47, 95% CI: 1.14, 1.91) and noncardiovascular disease-related (HR = 1.30, 95% CI: 1.03, 1.63) deaths. Both early and later life indicators of socioeconomic position contribute to increased mortality risk among socioeconomically disadvantaged women, but these effects appear stronger for cardiovascular mortality.
adult; cardiovascular diseases; child; mortality; risk; social class; socioeconomic factors; women
Abbreviations: Abbreviations: CI, confidence interval; HR, hazard ratio; ICD-9, International Classification of Diseases, Ninth Revision.
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