Several scientific research has shown that low socioeconomic status is an important health risk factor. It can be seen as a final sentence for those born in a family with disadvantaged conditions. But this is not an immutable destiny: if one succeeds in improving his/her status, not only economically but also culturally, the perspectives in terms of life expectancy and health improves sharply.
The so-called "life course trajectories" are the focus of a study conducted by the Department of Epidemiology and Prevention at the I.R.C.C.S. Neuromed, Italy, published in the Journal of Epidemiology and Community Health. Researchers analyzed the relationship between socioeconomic status over time and mortality in over 22,000 people recruited in the Moli-sani Study.
"Researches on socioeconomic status - says Marialaura Bonaccio, epidemiologist at the Department and first author of the study - usually focus on one or more indicators measured at a specific point of life. As an example, level of education can be assessed in young adulthood, but we do not know what happened before or after graduation. There are many possible combinations, and a person born in a disadvantaged family can improve, both culturally and socially. We wanted to study 'trajectories', the possible social paths that everyone can undertake during his/her life".
From the analysis of these trajectories it was possible to see how people who had a low socio-economic status during childhood, but later achieved a good level of education and a better economic situation, had a lower mortality risk than those who did not manage to improve themselves. Furthermore, life expectancy became similar to those who started with a more comfortable childhood.
And this is a journey that can also go backwards, as explained by Licia Iacoviello, Director of the Department and Professor of Hygiene and Public Health at the University of Insubria: "Another interesting aspect of the study is that subjects who had a good condition at childhood are likely to lose any advantage, in terms of survival, when they do not reach an adequate level of education. These data suggest that socio-economic circumstances in the first phase of life, disadvantageous or favorable, must be considered under the light of the subsequent evolution of individual socio-economic data ".
"It is an interesting, and very current, extension of the concept of 'social elevator' - says Giovanni de Gaetano, President of Neuromed - The socio-economic disadvantages in childhood do not represent a sentence without the possibility of appeal: cultural and economic improvements can counterbalance that initial negative situation. This study gives further scientific support to the need to do everything possible for a truly democratic society. According to many social researchers in Italy, in recent years the social elevator has stopped: those born poor remain poor, those born in a family with low education will not reach a high level of education. This is not just a problem for the quality of life of citizens: now we know that it is putting at risk people's health".
The Moli-sani Study
Started in March 2005, it involves about 25,000 citizens living in the Molise region. The aim is to learn about environmental and genetic factors underlying cardiovascular disease, cancer and degenerative pathologies. The Moli-sani Study, now based in the I.R.C.C.S. Neuromed, has transformed an entire Italian region in a large research lab.
The I.R.C.C.S. Neuromed
The Institute for Research, Hospitalization and Health Care (I.R.C.C.S.) Neuromed in Pozzilli (Italy) is a landmark, at Italian and international level, for research and therapy in the field of neurological and cardiovascular diseases. A centre in which doctors, researchers, staff and the patients themselves form an alliance aimed at ensuring the best level of service and cutting-edge treatments, guided by the most advanced scientific developments.
Journal of Epidemiology & Community Health