The effect of early-life and adult socioeconomic position on development of lifestyle-related diseases

Linda Ejlskov Jeppesen, Henrik Bøggild, Claus D Hansen, Jesper Wulff, Steen M Hansen, Liis Starkopf, Theis Lange, Thomas Gerds, Christian Torp-Pedersen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: Early-life socioeconomic position (SEP) is associated with lifestyle-related diseases in adulthood. However, evidence is lacking on the extent to which adult SEP mediates this association.

Methods: Time to either chronic obstructive pulmonary disease (COPD), cardiovascular disease or diabetes were assessed in the Danish population born between 1961 and 1971 (n = 793 674) from age 30 until 2015. Early-life position was assessed in 1981 (by parental) and again at age 30 (own) by four markers; income, occupation, education-divided into high, middle, low-and a combined score for all markers. Using a counterfactual approach, we estimated the total effect of early-life position on disease onset and the degree to which adult position mediated this effect.

Results: Results of the time-to-event analysis showed a gradient of all early-life markers on the risk of developing all lifestyle-related diseases. Notably, comparing those in the lowest to the highest educational position, the hazard of COPD was 130% higher for women [hazard ratio = 2.30(95% confidence interval = 2.20-2.41)] and 114% higher for men [2.14 (2.05-2.25)]. About 67%(63-70%) of the effect of educational position was mediated through adult position for COPD, 55% for cardiovascular disease and 50% for diabetes. For the combined score 44, 29 and 33%, respectively, was mediated.

Conclusion: About one-tenth to two-thirds of the effect of early-life position is mediated by the position attained in adulthood. The degree mediated depend on the outcome investigated, gender and the social position marker used indicating that alternative pathways may play a key role in developing effective policies targeting early-life behaviours.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Public Health
Vol/bind29
Udgave nummer3
Sider (fra-til)562-567
Antal sider6
ISSN1101-1262
DOI
StatusUdgivet - jun. 2019

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Life Style
Chronic Obstructive Pulmonary Disease
Cardiovascular Diseases
Occupations
Confidence Intervals
Education
Population

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@article{52a07d9ac25d4af18a1916d8536da682,
title = "The effect of early-life and adult socioeconomic position on development of lifestyle-related diseases",
abstract = "Background: Early-life socioeconomic position (SEP) is associated with lifestyle-related diseases in adulthood. However, evidence is lacking on the extent to which adult SEP mediates this association.Methods: Time to either chronic obstructive pulmonary disease (COPD), cardiovascular disease or diabetes were assessed in the Danish population born between 1961 and 1971 (n = 793 674) from age 30 until 2015. Early-life position was assessed in 1981 (by parental) and again at age 30 (own) by four markers; income, occupation, education-divided into high, middle, low-and a combined score for all markers. Using a counterfactual approach, we estimated the total effect of early-life position on disease onset and the degree to which adult position mediated this effect.Results: Results of the time-to-event analysis showed a gradient of all early-life markers on the risk of developing all lifestyle-related diseases. Notably, comparing those in the lowest to the highest educational position, the hazard of COPD was 130{\%} higher for women [hazard ratio = 2.30(95{\%} confidence interval = 2.20-2.41)] and 114{\%} higher for men [2.14 (2.05-2.25)]. About 67{\%}(63-70{\%}) of the effect of educational position was mediated through adult position for COPD, 55{\%} for cardiovascular disease and 50{\%} for diabetes. For the combined score 44, 29 and 33{\%}, respectively, was mediated.Conclusion: About one-tenth to two-thirds of the effect of early-life position is mediated by the position attained in adulthood. The degree mediated depend on the outcome investigated, gender and the social position marker used indicating that alternative pathways may play a key role in developing effective policies targeting early-life behaviours.",
author = "Jeppesen, {Linda Ejlskov} and Henrik B{\o}ggild and Hansen, {Claus D} and Jesper Wulff and Hansen, {Steen M} and Liis Starkopf and Theis Lange and Thomas Gerds and Christian Torp-Pedersen",
year = "2019",
month = "6",
doi = "10.1093/eurpub/cky237",
language = "English",
volume = "29",
pages = "562--567",
journal = "European Journal of Public Health",
issn = "1101-1262",
publisher = "Oxford University Press",
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The effect of early-life and adult socioeconomic position on development of lifestyle-related diseases. / Jeppesen, Linda Ejlskov; Bøggild, Henrik; Hansen, Claus D; Wulff, Jesper; Hansen, Steen M; Starkopf, Liis; Lange, Theis; Gerds, Thomas; Torp-Pedersen, Christian.

I: European Journal of Public Health, Bind 29, Nr. 3, 06.2019, s. 562-567.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - The effect of early-life and adult socioeconomic position on development of lifestyle-related diseases

AU - Jeppesen, Linda Ejlskov

AU - Bøggild, Henrik

AU - Hansen, Claus D

AU - Wulff, Jesper

AU - Hansen, Steen M

AU - Starkopf, Liis

AU - Lange, Theis

AU - Gerds, Thomas

AU - Torp-Pedersen, Christian

PY - 2019/6

Y1 - 2019/6

N2 - Background: Early-life socioeconomic position (SEP) is associated with lifestyle-related diseases in adulthood. However, evidence is lacking on the extent to which adult SEP mediates this association.Methods: Time to either chronic obstructive pulmonary disease (COPD), cardiovascular disease or diabetes were assessed in the Danish population born between 1961 and 1971 (n = 793 674) from age 30 until 2015. Early-life position was assessed in 1981 (by parental) and again at age 30 (own) by four markers; income, occupation, education-divided into high, middle, low-and a combined score for all markers. Using a counterfactual approach, we estimated the total effect of early-life position on disease onset and the degree to which adult position mediated this effect.Results: Results of the time-to-event analysis showed a gradient of all early-life markers on the risk of developing all lifestyle-related diseases. Notably, comparing those in the lowest to the highest educational position, the hazard of COPD was 130% higher for women [hazard ratio = 2.30(95% confidence interval = 2.20-2.41)] and 114% higher for men [2.14 (2.05-2.25)]. About 67%(63-70%) of the effect of educational position was mediated through adult position for COPD, 55% for cardiovascular disease and 50% for diabetes. For the combined score 44, 29 and 33%, respectively, was mediated.Conclusion: About one-tenth to two-thirds of the effect of early-life position is mediated by the position attained in adulthood. The degree mediated depend on the outcome investigated, gender and the social position marker used indicating that alternative pathways may play a key role in developing effective policies targeting early-life behaviours.

AB - Background: Early-life socioeconomic position (SEP) is associated with lifestyle-related diseases in adulthood. However, evidence is lacking on the extent to which adult SEP mediates this association.Methods: Time to either chronic obstructive pulmonary disease (COPD), cardiovascular disease or diabetes were assessed in the Danish population born between 1961 and 1971 (n = 793 674) from age 30 until 2015. Early-life position was assessed in 1981 (by parental) and again at age 30 (own) by four markers; income, occupation, education-divided into high, middle, low-and a combined score for all markers. Using a counterfactual approach, we estimated the total effect of early-life position on disease onset and the degree to which adult position mediated this effect.Results: Results of the time-to-event analysis showed a gradient of all early-life markers on the risk of developing all lifestyle-related diseases. Notably, comparing those in the lowest to the highest educational position, the hazard of COPD was 130% higher for women [hazard ratio = 2.30(95% confidence interval = 2.20-2.41)] and 114% higher for men [2.14 (2.05-2.25)]. About 67%(63-70%) of the effect of educational position was mediated through adult position for COPD, 55% for cardiovascular disease and 50% for diabetes. For the combined score 44, 29 and 33%, respectively, was mediated.Conclusion: About one-tenth to two-thirds of the effect of early-life position is mediated by the position attained in adulthood. The degree mediated depend on the outcome investigated, gender and the social position marker used indicating that alternative pathways may play a key role in developing effective policies targeting early-life behaviours.

UR - http://www.scopus.com/inward/record.url?scp=85066819811&partnerID=8YFLogxK

U2 - 10.1093/eurpub/cky237

DO - 10.1093/eurpub/cky237

M3 - Journal article

C2 - 30445458

VL - 29

SP - 562

EP - 567

JO - European Journal of Public Health

JF - European Journal of Public Health

SN - 1101-1262

IS - 3

ER -