Adult socioeconomic status is a more important predictor of coronary heart disease (CHD), chronic bronchitis, and depression than measures of social status earlier in life (as indicated by father's social class), according to findings from the Whitehall II study of 10,308 British civil servants. Researchers at London's University College prospectively studied these adults for a mean of 5.3 years to analyze the independent contribution of their employment grade and father's social class to prediction of these three diseases.
The researchers found that the lower one's employment grade, the higher the likelihood of CHD, chronic bronchitis, and depression in men (odds ratio per unit decrease in grade 1.30, 1.44, and 1.20, respectively; 1 is equal odds). After adjustment for father's social class, grade at entry into the civil service, and current grade, the strongest effect on adult disease was found for current grade. Even among adults with parents who lived beyond the age of 70, the inverse association of these three diseases and adult socioeconomic status was maintained.
In addition, of the high grade men, 1,186 of 2,953 came from low social class. Their heart disease rate was the same as that of high grade men from advantaged backgrounds but lower than that of low grade men. Similar results were found for women. This underscores the importance of addressing early life disadvantage because it influences adult circumstances rather than disease directly. Also, improving the conditions in which adults live and work is likely to improve disease risk independent of earlier disadvantage, conclude the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS06516).
More details are in "Relative contribution of early life and adult socioeconomic factors to adult morbidity in the Whitehall II study," by Michael G. Marmot, M.B., B.S., Ph.D., Martin Shipley, M.Sc., Eric Brunner, Ph.D., and Harry Hemingway, M.B., B.Chir., in the May 2001 Journal of Epidemiology and Community Health 55, pp. 301-307.
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