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Importance of early life factors lies in their influence on adult social circumstances

Relative contribution of early life and adult socioeconomic factors to adult morbidity in the Whitehall II study 2001; 55: 301-7

The importance of early life factors on adult health lies just as much in the influence they exert on adult social circumstances as on any direct "programming."

This month's Journal of Epidemiology and Community Health reports on over 10,000 British civil servants aged between 35 and 55, who were taking part in the Whitehall II study. The employees, ranging across 20 different departments from all administrative grades, were monitored for an average of five years to check for coronary artery disease, chronic bronchitis, and depression.

The higher the employment grade, the lower was the risk of all three diseases in men. There was a 30 per cent differential in the risk of developing heart disease between the highest and lowest grade. This was as high as 44 per cent for chronic bronchitis. Among women, those in higher grades were at greater risk of coronary heart disease and chronic bronchitis.

But current working grade had a much stronger impact on adult ill health than grade at entry into the Civil Service or father's social class. Even among people with long-lived parents, grade of employment still predicted ill health.

Among high grade employees, those who had originally come from less affluent backgrounds, had similar risks of heart disease as those from more advantaged backgrounds. But people in lower status jobs from less affluent backgrounds had higher risks.

The authors conclude that early life circumstances are important because of how they influence adult social circumstances. And these are important, they say, because of the way in which they affect health behaviours and disease risk.

Contact:

Professor Michael Marmot, International Centre for Health and Society, University College, London. M.Marmot@ucl.ac.uk

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