Effect of living conditions in the parental home and youth paths on the social class differences in mortality among women

Self-Injurious Behavior and Its Characteristics in a Sample of Mexican Adolescent Students

Adolescence is a difficult stage, a period of risk for developing disorders, including depression and self-injurious behavior. A non-random sample was drawn (n = 563) from first-year high school students (32.8%) 185 males and 378 females (67.14%) from public schools in Mexico. The age range was 15 and 19 years, with a mean age of 15.63 (SD = 0.78). According to the results, the sample was divided into n1 = 414 (73.3%) adolescents without self-injury (S.I.) and n2 = 149 (26.4%) S.I. adolescents. In addition, results were obtained on methods, motives, time, and frequency of S.I., and a model was generated in which depression and first sexual experience obtained the highest Odd Ratio and d values in their relationship with S.I. Finally, we contrasted the results with earlier reports and concluded that depression is an important variable in S.I. behavior. Early S.I. detection will prevent the aggravation of S.I. and suicide attempts.

The association of early life socioeconomic position on breast cancer incidence and mortality: a systematic review

OBJECTIVES

We conducted a systematic review of the literature relating early life socioeconomic position (SEP) to breast cancer incidence and mortality from a critical period and life-course trajectory perspective.

METHODS

PubMed, EMBASE and Web of Science were searched to identify cohort studies that evaluated the impact of early life SEP indicators on the incidence and/or mortality from breast cancer in adulthood.

RESULTS

Nine distinct studies evaluated the relationship between early life SEP and breast cancer between 1990 and 2016. Five reports assessed breast cancer incidence and five assessed breast cancer mortality as outcomes; one study assessed both incidence and mortality. While lower early life SEP was associated with reduced breast cancer incidence and increased breast cancer mortality in the US, studies conducted in Europe were unable to establish a consistent association.

CONCLUSIONS

We found moderate support for the association between early life SEP and incidence and mortality from breast cancer. The impact of early life SEP on breast cancer incidence and mortality appeared to vary between countries. We urge further investigation of the role of lifelong SEP trajectories in breast cancer outcomes.

Socioeconomic position in childhood and cancer in adulthood: a rapid-review

Background

The relationship of childhood socioeconomic position (SEP) to adult cancer has been inconsistent in the literature and there has been no review summarising the current evidence focused solely on cancer outcomes.

Methods and results

We performed a rapid review of the literature, which identified 22 publications from 13 studies, primarily in the UK and northern European countries that specifically analysed individual measures of SEP in childhood and cancer outcomes in adulthood. Most of these studies adjusted for adult SEP as a critical mediator of the relationship of interest.

Conclusions

Results confirm that childhood socioeconomic circumstances have a strong influence on stomach cancer and are likely to contribute, along with adult circumstances, to lung cancer through cumulative exposure to smoking. There was also some evidence of increased risk of colorectal, liver, cervical and pancreatic cancers with lower childhood SEP in large studies, but small numbers of cancer deaths made these estimates imprecise. Gaps in knowledge and potential policy implications are presented.

Childhood family background and mortality differences by income in adulthood: fixed-effects analysis of Finnish siblings

BACKGROUND

Events and conditions during childhood have been found to affect health and mortality at later stages in life. We studied whether childhood conditions explain the observed all-cause and cause-specific mortality disparity between income groups in adulthood.

METHODS

We used a 10% register linked sample of Finnish households in the 1950 census identifying 51 647 children aged 0-14 with at least one sibling of the same sex and followed them for mortality from the age 35 until ages 57-72. Using Cox regression with sibling design, we estimated hazard ratios (HRs) for quintiles of personal income at the age 35. We controlled for observed childhood family sociodemographic characteristics and allowed different baseline hazard functions for each group of siblings in order to control for all shared unobserved characteristics within families.

RESULTS

Accounting for the observed childhood characteristics did not attenuate the income disparity in mortality, whereas adjusting for the sociodemographic characteristics in adulthood reduced the difference of the lowest quintiles by ∼70% among men and 30-40% among women. Controlling for the unobserved childhood characteristics in the sibling design did not provide any further explanation to the income differentials in mortality. This applied also for cause-specific mortality among men. HR to the cardiovascular diseases was 38% higher and 73% higher in alcohol, accidental and violent causes in the lowest quintile even after adjusting for all observed and unobserved characteristics.

CONCLUSIONS

The excess mortality in the lowest income quintiles persists even after shared childhood family conditions among siblings are accounted for.

Parental socio-economic position during childhood as a determinant of self-harm in adolescence

PURPOSE

Socio-economic position (SEP) during childhood and parental social mobility have been associated with subsequent health outcomes in adolescence and adulthood. This study investigates whether parental SEP during childhood is associated with subsequent self-harm in adolescence.

METHODS

This study uses data from a prospective birth-cohort study (the Avon Longitudinal Study of Parents and Children) which followed 14,610 births in 1991-1992 to age 16-18 years (n = 4,810). The association of parental SEP recorded pre-birth and throughout childhood with self-harm was investigated using logistic regression models, with analyses conducted separately for those reporting self-harm (a) with and (b) without suicidal intent. The impact of missing data was investigated using multiple imputation methods.

RESULTS

Lower parental SEP was associated with increased risk of offspring self-harm with suicidal intent, with less consistent associations evident for self-harm without suicidal intent. Associations were somewhat stronger in relation to measures of SEP in later childhood. Depressive symptoms appeared to partially mediate the associations. Adolescents of parents reporting consistently low income levels during childhood were approximately 1.5 times more likely to engage in SH than those never to report low income.

CONCLUSIONS

Lower SEP during childhood is associated with the subsequent risk of self-harm with suicidal intent in adolescence. This association is stronger in those experiencing consistently lower SEP.

Early life financial adversity and respiratory function in midlife: a prospective birth cohort study

Data from the 1958 National Child Development Study (1958-2004) were used in a prospective study of the relation of financial adversity in childhood to lung function in midlife. It was hypothesized that such a relation would be found and would be mediated partly by early housing deprivation, partly by continuities in social disadvantage, and partly by smoking. These hypotheses were confirmed. The mediating variables explained nearly two-thirds of the observed relation. The strongest individual pathway from early financial hardship to adult lung function was through poor housing in childhood. Poor housing increased the risk of educational failure, which in turn was strongly related to less-advantaged social class. Lack of educational qualifications and less-advantaged social class independently increased the risk of higher levels of smoking. Mediating variables therefore acted in part as indicators of environmental exposures and in part through their links to adult smoking. Early financial adversity is associated with adult lung function partly through poor housing and partly through pathways involving continuities in social disadvantage and the associated environmental exposures and behaviors.

Losing life and livelihood: a systematic review and meta-analysis of unemployment and all-cause mortality

Unemployment rates in the United States remain near a 25-year high and global unemployment is rising. Previous studies have shown that unemployed persons have an increased risk of death, but the magnitude of the risk and moderating factors have not been explored. The study is a random effects meta-analysis and meta-regression designed to assess the association between unemployment and all-cause mortality among working-age persons. We extracted 235 mortality risk estimates from 42 studies, providing data on more than 20 million persons. The mean hazard ratio (HR) for mortality was 1.63 among HRs adjusted for age and additional covariates. The mean effect was higher for men than for women. Unemployment was associated with an increased mortality risk for those in their early and middle careers, but less for those in their late career. The risk of death was highest during the first 10 years of follow-up, but decreased subsequently. The mean HR was 24% lower among the subset of studies controlling for health-related behaviors. Public health initiatives could target unemployed persons for more aggressive cardiovascular screening and interventions aimed at reducing risk-taking behaviors.

Self-reported mental health and its gender differences as a predictor of suicide in the middle-aged

Studies of clinical cohorts and retrospective reports have identified psychiatric disorders as paramount risk factors for suicide. Much less is known about how self-reported mental health is related to completed suicide. To study the relation between self-reported mental health and risk of completed suicide, the authors prospectively followed a population-based Norwegian cohort of 61,588 men and 69,774 women aged 39-44 years for an average of 10.4 years between 1994 and 2007. Self-reported mental health was measured using an instrument based on the Hopkins Symptom Checklist and the General Health Questionnaire. Completed suicides were registered in the official Norwegian Cause of Death Registry. Females reported higher levels of mental distress than males. In comparison with persons reporting the fewest mental health symptoms, the adjusted hazard ratio for suicide increased from 1.8 (95% confidence interval (CI): 1.1, 2.9) in the moderately depressed group to 8.9 (95% CI: 4.4, 18.2) in the most depressed group. The risk difference was greatest in males. At each level of the mental health index, males had double the risk of suicide of females (hazard ratio = 2.3, 95% CI: 1.5, 3.3). This study shows a dose-response effect of self-reported mental health problems on completed suicide and replicates the gender paradox observed in the general population with prospective data.

Childhood and adulthood socioeconomic position across 20 causes of death: a prospective cohort study of 800,000 Norwegian men and women

OBJECTIVE

To assess the impact of childhood and adulthood socioeconomic position (SEP) across 20 causes of death in a large population-wide sample of Norwegian men and women.

METHODS

Census data on parental occupational class from 1960 and data from the tax register on household income in 1990 were linked to the death register for 1990-2001, and 20 causes of death were studied. Relative indices of inequalities were computed. Norwegians in the age group 0-20 years in 1960 and still alive in 1990 were followed for deaths in 1990 to 2001. This follow up involved 795,324 individuals (78%) and 20,887 deaths.

MAIN RESULTS

In men most support for an effect of childhood socioeconomic position was found for stomach cancer, lung cancer, coronary heart disease, "other violent death", and all causes of death. In women similar effects were found for lung cancer, cervical cancer, coronary heart disease, chronic obstructive pulmonary disease, and all causes of death.

CONCLUSIONS

The effect of childhood socioeconomic position relative to adulthood varies by cause of death. Although there are some exceptions, the patterns in men and women are generally similar.

Cause-specific mortality at young ages: lessons from Finland

This paper analyses cause-specific mortality in ages 15-30 years in Finland, using longitudinal population register data that covers the period 1970-2004. The aim is to see how mortality risks interrelate with living conditions in the parental home and with regional confounders, in order to understand why the two native population groups of the country differ in mortality. Results based on Cox proportional hazard models reveal that, in young men, socio-economic circumstances interrelate with external causes of death excluding suicides, probably because of social class differences in hazardous lifestyles. Thus injuries and accidents, but not suicides, depend on socio-economic background. For suicides, we find a regional mortality pattern that is highly similar to variation in overall mortality at higher ages, whereas for all other external causes of death such differences cannot be observed. These results suggest that hereditary factors cannot be ruled out as an explanation to the population-group mortality gradient.

Childhood socioeconomic status and suicide mortality in early adulthood among Norwegian men and women. A prospective study of Norwegians born between 1955 and 1965 followed for suicide from 1990 to 2001

Even though the causes of suicide may be rooted in childhood, it is unknown how socioeconomic position (SEP) in childhood is related to suicide in adulthood. We describe the association between childhood SEP and suicide mortality in adulthood in Norway using registry data on 613807 Norwegians born in 1955-1965. Data on 1013 suicide deaths between 1990 and 2001 were linked to data on SEP indicators, using Cox regression. Suicide mortality was higher among women with high childhood SEP than among women with low childhood SEP. This association was explained in part by family situation in adulthood, but not by adult SEP. For males, after adjustment for adult SEP, we observed a similar but weaker association between suicide and childhood SEP. We discuss several mechanisms which may explain the direct positive association of childhood SEP with suicide mortality in adulthood, especially among females. These are downward mobility, not meeting high demands set by highly educated parents, psychological distress, mental disorder, gender differences and social networks and norms.

Systematic Review of the Influence of Childhood Socioeconomic Circumstances on Risk for Cardiovascular Disease in Adulthood

PURPOSE

Adverse socioeconomic circumstances in childhood may confer a greater risk for adult cardiovascular disease (CVD). The purpose of this review is to systematically evaluate evidence for an association between socioeconomic circumstances during childhood and specific CVD subtypes, independent of adult socioeconomic conditions.

METHODS

We systematically retrieved individual-level studies of morbidity and mortality from CVD and specific CVD subtypes linked to early life influences, including coronary heart disease (CHD), ischemic and hemorrhagic stroke, peripheral vascular disease, markers of atherosclerosis (carotid intima-media thickness and stenosis), and rheumatic heart disease. Indicators of socioeconomic position in childhood varied, although most studies relied on father's occupation.

RESULTS

We located 40 studies (24 prospective, 11 case-control, and 5 cross-sectional) reported in 50 publications. Thirty-one studies (19 prospective, 7 case-control, and all 5 cross-sectional) found a robust inverse association between childhood circumstances and CVD risk, although findings sometimes varied among specific outcomes, socioeconomic measures, and sex. Case-control studies reported mixed results. The association was stronger for stroke and, in particular, hemorrhagic stroke, than for CHD. Childhood socioeconomic conditions remained important predictors of CVD, even in younger cohorts.

CONCLUSION

Childhood and adulthood socioeconomic circumstances are important determinants of CVD risk. The specific contribution of childhood and adulthood characteristics varies across different CVD subtypes. Disease-specific mechanisms are likely to explain the childhood origins of these adult health inequalities.

Socioeconomic position in childhood and early adult life and risk of mortality: a prospective study of the mothers of the 1958 British birth cohort

OBJECTIVES

We sought to establish whether women's childhood socioeconomic position influenced their risk of mortality separately from the effects of adult socioeconomic position.

METHODS

We examined 11855 British women aged 14 to 49 years, with mortality follow-up over a 45-year period.

RESULTS

Trends according to childhood social class were observed for all-cause mortality, circulatory disease, coronary heart disease, respiratory disease, chronic obstructive pulmonary disease, stroke, lung cancer, and stomach cancer, with higher death rates among members of unskilled manual groups. Associations attenuated after adjustment for adult social class, smoking, and body mass index. No trend was seen for breast cancer or accidents and violence. Adverse social conditions in both childhood and adulthood were associated with higher death rates from coronary heart disease and respiratory disease. Stomach cancer was influenced primarily by childhood conditions and lung cancer by factors in adult life.

CONCLUSIONS

Socioeconomic position in childhood was associated with adult mortality in a large sample of British women.

Life-course experiences and mortality by adult social class among young men

Circumstances over the life-course may contribute to adult social class differences in mortality. However, it is only rarely that the life-course approach has been applied to mortality studies among young adults. The aim of this study is to determine to what extent social class differences in mortality among young Finnish men are explained by living conditions in the parental home and life paths related to transitions in youth. The data for males born in 1956-60 based on the 1990 census records are linked with death records (3184 deaths) by cause of death for 1991-98, and with information on life-course circumstances from the 1970, 1975, 1980, and 1985 censuses. Controlling for living conditions in the parental home-social class, family type, number of siblings, language and region of residence-reduced the high excess mortality of the lower non-manual (RR 1.51, 95% CI: 1.28-1.79), skilled manual (RR 2.94, 2.54-3.40), and unskilled manual class (RR 4.08, 3.51-4.73) by 10% in all-cause mortality. The equivalent reduction for cardiovascular disease was 28% and for alcohol-related causes 16%. The effect of parental home on mortality differences was mainly mediated through its effect on youth paths (pathway model). Educational, marital, and employment paths had a substantial effect-independent of parental home-on social class differences from various causes of death. When all these variables were controlled for adult social class differences in cause specific mortality were reduced by 75-86%. Most of this reduction in mortality differences can be attributed to educational path. However, marital and employment paths had their independent effects, particularly on the excess mortality of unskilled manual workers with disproportionately common exposure to long-term unemployment and living without a partner. In summary, social class differences in total mortality among men in their middle adulthood were only partly determined by parental home but they were mainly attributable to educational, marital, and employment paths in youth.