ArticleJournal of epidemiology and community health2014
Association of socioeconomic position with smoking and mortality: the contribution of early life circumstances in the 1946 birth cohort.
Article in Journal of epidemiology and community health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- A Randomized Trial of Incentives for Smoking Treatment in Medicaid Members.American journal of preventive medicine · 2017Trial
- Mental stress as a trigger of cardiovascular events: A narrative review.European journal of clinical investigation · 2026Review
- Psychosocial stress and cardiovascular disease.American journal of preventive cardiology · 2025Review
- The association between total social exposure and incident multimorbidity: A population-based cohort study.SSM - population health · 2025Article
- Social determinants of health and clinical outcomes among patients with atrial fibrillation: evidence from a global federated health research network.QJM : monthly journal of the Association of Physicians · 2024Article
- Intergenerational educational trajectories and inequalities in longevity: A population-based study of adults born before 1965 in 14 European countries.SSM - population health · 2023Article
- Gender differences in the association between adverse events in childhood or adolescence and the risk of premature mortality.Scientific reports · 2022Article
- Burden of current and past smoking across 28 European countries in 2017: A cross-sectional analysis.Tobacco induced diseases · 2022Article
- Childhood Socioeconomic Position, Adult Educational Attainment and Health Behaviors: The Role of Psychological Capital and Health Literacy.International journal of environmental research and public health · 2021Article
- Special Report: The Biology of Inequalities in Health: The Lifepath Consortium.Frontiers in public health · 2020Article
- The National Institute on Minority Health and Health Disparities Research Framework.American journal of public health · 2019Article
- A cohort study on self-reported role stressors at work and poor sleep: does sense of coherence moderate or mediate the associations?International archives of occupational and environmental health · 2018Article
- Vulnerable children, stigmatised smokers: The social construction of target audiences in media debates on policies regulating smoking in vehicles.Health (London, England : 1997) · 2017Article
- Retrospective Reports of Negative Early Life Events Over a 4-Year Period: A Test of Measurement Invariance and Response Consistency.The journals of gerontology. Series B, Psychological sciences and social sciences · 2017Article
- Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey.Preventive medicine reports · 2017Article
- Social factors and cardiovascular morbidity.Neuroscience and biobehavioral reviews · 2017Review
- Life course socioeconomic adversities and 10-year risk of cardiovascular disease: cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health.International journal of public health · 2017Article
- Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2017Article
- The effects of maximising the UK's tobacco control score on inequalities in smoking prevalence and premature coronary heart disease mortality: a modelling study.BMC public health · 2016Article
- Impact of lifestyle dimensions on brain pathology and cognition.Neurobiology of aging · 2016Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundA large part of the socioeconomic mortality gradient can be statistically accounted for by social patterning of adult health behaviours. However, this statistical explanation does not consider the early life origins of unhealthy behaviours and increased mortality risk.
methodsAnalysis is based on 2132 members of the MRC National Survey of Health and Development with mortality follow-up and complete data. Smoking behaviour was summarised by pack-years of exposure. Socioeconomic circumstances were measured in childhood (father's social class (age 4), maternal education (age 6)) and age 26 (education attainment, home ownership, head of household social class). We estimated the direct effect of early circumstances, the indirect effect through smoking and the independent direct effect of smoking on inequality in all-cause mortality from age 26 to 66.
resultsMortality risk was higher in those with lower socioeconomic position at age 26, with a sex-adjusted HR (relative index of inequality) of 1.97 (95% CI 1.18 to 3.28). Smoking and early life socioeconomic indicators together explained 74% of the socioeconomic gradient in mortality (the gradient). Early life circumstances explained 47% of the gradient, 23.5% directly and 23.0% indirectly through smoking. The explanatory power of smoking behaviour for the gradient was reduced from 50.8% to 28% when early life circumstances were added to the model.
conclusionsEarly life socioeconomic circumstances contributed importantly to social inequality in adult mortality. Our life-course model focusing on smoking provides evidence that social inequalities in health will persist unless prevention strategies tackle the intergenerational transmission of disadvantage and risk.
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