Low childhood socioeconomic status closely linked to poor adult health

Authors of a New Zealand population study in this week's issue of THE LANCET highlight how adult health is directly related to socio-economic status in childhood--poorer children are more likely to be affected by adverse health outcomes later in life.

Research into social inequalities in health has tended to focus on low socioeconomic status in adulthood. Richie Poulton from the University of Otago, New Zealand, and colleagues studied 1000 children (born in New Zealand during 1972–73) who had been assessed throughout childhood. The investigators assessed the study population at age 26 for various health outcomes including body-mass index, waist:hip ratio, blood pressure, cardiorespiratory fitness, dental health, major depression, and tobacco and alcohol dependency.

Children who grew up in low socioeconomic status families had poorer cardiovascular health in adulthood compared with those from high socioeconomic status backgrounds. Children from poorer backgrounds were also three times more likely to have adult periodontal disease, and were twice as likely to have alcohol dependency. Upward mobility in socio-economic status during childhood did not reverse the increase in negative health outcomes associated with a poor childhood environment.

Richie Poulton comments: "Protecting children against the effects of socioeconomic adversity could reduce the burden of disease experienced by adults. These findings provide strong impetus for policy makers, practitioners, and researchers to direct energy and resources towards childhood as a way of improving population health."

In an accompanying Commentary ( p 1619), Chris Power from the Institute for Child Health, London, UK, comments: "Why should childhood circumstances affect adult health even in a younger generation? One thought-provoking possibility is that adversity in childhood becomes embodied at an early age, the full impact of which manifests later in adult life. The interplay between biological and social processes could start with exposure to frequent infections or inadequate diet, both rooted in poorer socioeconomic conditions, and such exposures could in turn have lifelong consequences."

Contact: Dr Richie Poulton, Dunedin Multidisciplinary Health & Development Research Unit,
Department of Preventive & Social Medicine, Dunedin School of Medicine,
University of Otago, PO Box 913 Dunedin, New Zealand;
E) richiep@gandalf.otago.ac.nz

Dr Chris Power, Institute of Child Health, London WC1N 1EH, UK;
E) c.power@ich.ucl.ac.uk

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