Cause-specific hospital admission and mortality among working men: association with socioeconomic circumstances in childhood and adult life, and the mediating role of daily stress

Metcalfe, C., Davey Smith, G., Sterne, J.A.C., Heslop, P., MacLeod, J. and Hart, C.L. (2005) Cause-specific hospital admission and mortality among working men: association with socioeconomic circumstances in childhood and adult life, and the mediating role of daily stress. European Journal of Public Health, 15(3), pp. 238-244. (doi: 10.1093/eurpub/cki063)

Abstract

BACKGROUND: The aim of this study was to investigate the association of childhood and adulthood social class with the occurrence of specific diseases, including those not associated with a high mortality rate, and to investigate daily stress as the mechanism for that part of any association which cannot be accounted for by established risk factors. METHODS: This was a prospective cohort study with 25 years of follow-up for cause-specific morbidity and mortality. A total of 5577 Scottish men were recruited from 27 workplaces in the West of Scotland. Childhood social class was determined from the occupation held by the individual's father, and adulthood social class from the individual's occupation at enrolment. Daily stress was measured at enrolment using the Reeder Stress Inventory. RESULTS: Health differentials were found for cardiovascular diseases, lung cancer, peptic ulcer, asthma, accidents and violence, alcohol-related diseases, and perhaps psychiatric illness. Adulthood circumstances were associated with the incidence of most diseases in adulthood, the exception being stroke, which was strongly associated with less privileged circumstances in childhood. Both childhood and adulthood circumstances contributed to the incidence of coronary heart disease. Daily stress did not underlie any of these associations once the influence of established risk factors had been taken into account. CONCLUSIONS: Socioeconomic circumstances in childhood and adulthood both contribute to health differentials in adulthood, the relative contributions depending upon the particular disease. Where known risk factors explained only part of the excess of a disease among individuals raised or living in less-privileged circumstances, there was no evidence to suggest that daily stress was the reason for the unexplained excess.

• Item Type: Articles
• Keywords: life-course exposure, psychological stress, socioeconomic position
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Davey Smith, Professor George
• Authors: Metcalfe, C., Davey Smith, G., Sterne, J.A.C., Heslop, P., MacLeod, J., and Hart, C.L.
• Subjects: R Medicine > RA Public aspects of medicine; R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
• College/School: College of Medical Veterinary and Life Sciences
• Research Group: Midspan
• Journal Name: European Journal of Public Health
• Publisher: Oxford University Press
• ISSN: 1102-1262
• Copyright Holders: Copyright © 2005 Oxford University Press
• First Published: First published in European Journal of Public Health 15(3):238-244
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher