Can large relative mortality differences between socio-economic groups among Swedish men be explained by risk indicator-associated social mobility?
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BACKGROUND: The Nordic countries, profiled as welfare states, are shown to have comparatively large relative socio-economic differences in mortality and comparatively high intergenerational mobility. The aim of this study was to analyse the role of risk indicator-associated social mobility (from childhood through to adulthood) in socio-economic mortality differences among Swedish men aged 35-50 years. METHODS: We used data on risk indicators for adult mortality (risk use of alcohol, smoking, low emotional control, psychiatric diagnosis, medication for nervous problems, contact with police and child care, experience of unemployment, low body height, low education) collected at compulsory conscription for military training among Swedish men at aged 18-20, fathers' socio-economic status at subjects' ages 9-11 years, data on subjects' socio-economic status at ages 34-36 years, and follow-up data on mortality during 1986-1999 (at ages 35-50 years). RESULTS: Persons in manual occupations in 1985 showed an elevated relative risk (RR) of mortality compared with stable non-manual employees regardless of the social position of their father (RR 1.75 among stable manual workers, and RR 1.74 among the downwardly mobile). In multivariate analyses, taking into account the risk indicators first operating in late adolescence, the increased mortality risk among stable manual workers and also among the downwardly mobile diminished considerably (RR 1.32 and 1.39, respectively). CONCLUSIONS: These results suggest that a substantial part of the socio-economic differences in mortality among middle-aged men had their origin in childhood circumstances. Risk indicator-associated social mobility was found to contribute substantially to an increase in the relative difference in mortality between male manual workers and non-manual employees. (+info)
Social mobility over the lifecourse and self reported mental health at age 50: prospective cohort study.
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STUDY OBJECTIVE: To investigate the effect of socioeconomic status throughout the lifecourse on self reported mental health at age 50 years. DESIGN: Prospective cohort study SETTING: Community setting in Newcastle upon Tyne, north east England. PARTICIPANTS: 503 subjects from a birth cohort assembled in 1947 who completed the 28 item version of the general health questionnaire (GHQ-28). MAIN RESULTS: There was an association between socioeconomic group at birth and reporting a clinically significant GHQ-28 score at age 50 (OR 5.5 95% CI 1.2 to 25.4 comparing the least with the most advantaged socioeconomic group). A downward socioeconomic trajectory over the whole lifecourse was associated with poorer self reported mental health in men (p<0.001) but not women (p=0.8). CONCLUSIONS: Socioeconomic position throughout the lifecourse may act differently on mental health at middle age depending on a person's sex. (+info)
Similar support for three different life course socioeconomic models on predicting premature cardiovascular mortality and all-cause mortality.
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BACKGROUND: There are at least three broad conceptual models for the impact of the social environment on adult disease: the critical period, social mobility, and cumulative life course models. Several studies have shown an association between each of these models and mortality. However, few studies have investigated the importance of the different models within the same setting and none has been performed in samples of the whole population. The purpose of the present study was to study the relation between socioeconomic position (SEP) and mortality using different conceptual models in the whole population of Scania. METHODS: In the present investigation we use socioeconomic information on all men (N = 48,909) and women (N = 47,688) born between 1945 and 1950, alive on January, 1st,1990, and living in the Region of Scania, in Sweden. Focusing on three specific life periods (i.e., ages 10-15, 30-35 and 40-45), we examined the association between SEP and the 12-year risk of premature cardiovascular mortality and all-cause mortality. RESULTS: There was a strong relation between SEP and mortality among those inside the workforce, irrespective of the conceptual model used. There was a clear upward trend in the mortality hazard rate ratios (HRR) with accumulated exposure to manual SEP in both men (p for trend < 0.001 for both cardiovascular and all-cause mortality) and women (p for trend = 0.01 for cardiovascular mortality) and (p for trend = 0.003 for all-cause mortality). Inter- and intragenerational downward social mobility was associated with an increased mortality risk. When applying similar conceptual models based on workforce participation, it was shown that mortality was affected by the accumulated exposure to being outside the workforce. CONCLUSION: There was a strong relation between SEP and cardiovascular and all-cause mortality, irrespective of the conceptual model used. The critical period, social mobility, and cumulative life course models, showed the same fit to the data. That is, one model could not be pointed out as "the best" model and even in this large unselected sample it was not possible to adjudicate which theories best describe the links between life course SEP and mortality risk. (+info)
Childhood leukaemia and socioeconomic status: fact or artefact? A report from the United Kingdom childhood cancer study (UKCCS).
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BACKGROUND: It is widely believed that children of high socioeconomic status (SES) are more likely than those of low SES to develop acute lymphoblastic leukaemia (ALL). Such observations have led to wide-ranging speculations about the potential aetiological role of factors associated with affluence and modernization. METHODS: Children (0-14 years) newly diagnosed with cancer in the UK between 1991 and 1996 were ascertained via a rapid hospital-based case finding system (n = 4430, of which 1578 were ALL). Children without cancer (controls) were randomly selected from primary care population registries for comparative purposes (n = 7763). Area-based deprivation scores were assigned as markers of SES at two time points - birth and diagnosis. An individual-based marker of SES - social class - was assigned using father's occupation as recorded on the child's birth certificate. RESULTS: No differences in area-based measures of deprivation were observed between cases and controls at time of diagnosis, either for all cancers combined [n = 4430, odds ratio (OR) = 1.00 (95% confidence intervals (CI) 0.98-1.01)] or for ALL alone (n = 1578 OR = 0.99, 95%CI 0.96-1.01). Findings were similar at time of birth (all cancers, OR = 0.99 95%CI 0.98-1.01, ALL OR = 0.98, 95%CI 0.96-1.00). In addition, no case-control differences were observed when an individual-based measure of SES - social class - based on father's occupation at time of birth was used. CONCLUSIONS: The comprehensive nature of the data, coupled with complete case-ascertainment and representative population-based controls suggests that SES in the UK is not a determinant of ALL in children. We believe the small effects reported for SES in some past studies may be artefactual. (+info)
Maternal upward socioeconomic mobility and black-white disparities in infant birthweight.
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OBJECTIVES: We estimate the extent to which upward socioeconomic mobility limits the probability that Black and White women who spent their childhoods in or near poverty will give birth to a low-birthweight baby. METHODS: Data from the National Longitudinal Survey of Youth 1979 and the 1970 US Census were used to complete a series of logistic regression models. We restricted multivariate analyses to female survey respondents who, at 14 years of age, were living in households in which the income-to-needs ratio did not exceed 200% of poverty. RESULTS: For White women, the probability of giving birth to a low-birthweight baby decreases by 48% for every 1 unit increase in the natural logarithm of adult family income, once the effects of all other covariates are taken into account. For Black women, the relation between adult family income and the probability of low birthweight is also negative; however, this association fails to reach statistical significance. CONCLUSIONS: Upward socioeconomic mobility contributes to improved birth outcomes among infants born to White women who were poor as children, but the same does not hold true for their Black counterparts. (+info)
Lifelong socioeconomic trajectory and premature mortality (35-65 years) in France: findings from the GAZEL Cohort Study.
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BACKGROUND: Studies conducted in the UK and Scandinavia show an inverse association between lifetime socioeconomic position and adult mortality. However, there are virtually no data from other countries and few investigations have examined non-cardiovascular mortality in men and women. METHODS: Lifelong socioeconomic trajectories (father's occupation, own occupation in young adulthood and in mid-life) and premature (< or = 65 years) mortality (all-cause, smoking-related cancer, diseases of the circulatory system and external causes) in the French GAZEL Cohort Study (14,972 men and 5,598 women, followed up between 1990 and 2004) were studied. Hazard ratios (HRs) were estimated using Cox's regression models adjusted for age, marital status, tobacco smoking, alcohol consumption, body mass index, and fruit and vegetable consumption. RESULTS: Men and women who experienced lifelong disadvantage or downward intergenerational mobility were at high risk of dying prematurely compared with those with a favourable trajectory (age-adjusted HRs for all-cause mortality: cumulative disadvantage: HR 1.61, 95% confidence interval (CI) 1.26 to 2.06 in men and HR 1.95, 95% CI 1.10 to 3.47 in women; downward mobility: HR 1.87, 95% CI 1.35 to 2.58 in men and HR 2.05, 95% CI 1.12 to 3.75 in women). Associations were strongest for mortality due to chronic diseases (smoking-related cancers and diseases of the circulatory system). These associations were partly explained by marital status, body mass index, alcohol consumption, cigarette smoking, and fruit and vegetable consumption. CONCLUSIONS: In France, where the leading cause of premature death is cancer, lifelong socioeconomic position is associated with the risk of dying before the age of 65 years. Adult factors seem more relevant than childhood socioeconomic circumstances. (+info)
The mental health of Black Caribbean immigrants: results from the National Survey of American Life.
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OBJECTIVES: We examined the prevalence of psychiatric disorders among Black Caribbean immigrant ("Caribbean Black") and African American populations and the correlates of psychiatric disorders among the Caribbean Black population. METHODS: We conducted descriptive and age-adjusted analyses of the data from the National Survey of American Life--an in-person household mental health survey of noninstitutionalized US Blacks. We assessed psychiatric disorders as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria with the Composite International Diagnostic Interview. RESULTS: Compared with African American men, Caribbean Black men had higher risks for 12-month rates of psychiatric disorders. Caribbean Black women had lower odds for 12-month and lifetime psychiatric disorders compared with African American women. Risks varied by ethnicity, immigration history, and generation status within the Caribbean sample. First-generation Caribbean Blacks had lower rates of psychiatric disorders compared with second- or third-generation Caribbean Blacks, and, compared with first-generation Caribbean Blacks, third-generation Caribbean Blacks had markedly elevated rates of psychiatric disorders. CONCLUSIONS: Mental health risks were associated with ethnic diversity within the US Black population. Increased exposure to minority status in the United States was associated with higher risks for psychiatric disorders among Black Caribbean immigrants, which possibly reflects increased societal stress and downward social mobility associated with being Black in America. (+info)
Working-class royalty: bees beat the caste system.
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The struggle among social classes or castes is well known in humans. Here, we show that caste inequality similarly affects societies of ants, bees and wasps, where castes are morphologically distinct and workers have greatly reduced reproductive potential compared with queens. In social insects, an individual normally has no control over its own fate, whether queen or worker, as this is socially determined during rearing. Here, for the first time, we quantify a strategy for overcoming social control. In the stingless bee Schwarziana quadripunctata, some individuals reared in worker cells avoid a worker fate by developing into fully functional dwarf queens. (+info)