Is the association between childhood socioeconomic circumstances and cause-specific mortality established?
Update of a systematic review
B Galobardes1, J
1 Department of Social Medicine, University of Bristol, UK
2 Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
Journal of Epidemiology and Community Health - May 2008 - Volume 62, Number 5
Objective: To update a systematic review on the association between childhood socioeconomic circumstances and cause-specific mortality. Studies published since 2003 include a far greater number of deaths than was previously available justifying an update of the previous systematic review.
Methods: Individual-level studies examining childhood socioeconomic circumstances and adult overall and cause-specific mortality published between 2003 and April 2007.
Results and conclusions: The new studies confirmed that mortality risk for all causes was higher among those who experienced poorer socioeconomic circumstances during childhood. As already suggested in the original systematic review, not all causes of death were equally related to childhood socioeconomic circumstances. A greater proportion of new studies included women and showed that a similar pattern is valid for both genders. In addition, the new studies show that this association persists among younger birth cohorts, despite temporal general improvements in childhood conditions across successive birth cohorts. The difficulties of establishing a particular life-course model were highlighted
What this paper adds
- The association between childhood socioeconomic circumstances and cause-specific mortality is present in men and women.
- This association persists in younger cohorts despite them not having been exposed to the same sort of childhood hardships as previous cohorts
- Education is an important mediator between early life socioeconomic position and adult mortality
This systematic review provides strong evidence that poor socioeconomic circumstances during childhood are associated with higher mortality among men and women and that this association persists among younger cohorts. Tackling health inequalities from the start of life needs to be a policy priority if we are to reduce adult health inequalities.
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