摘要：Objectives. We sought to establish whether women’s childhood socioeconomic position influenced their risk of mortality separately from the effects of adult socioeconomic position. Methods. We examined 11855 British women aged 14 to 49 years, with mortality follow-up over a 45-year period. Results. Trends according to childhood social class were observed for all-cause mortality, circulatory disease, coronary heart disease, respiratory disease, chronic obstructive pulmonary disease, stroke, lung cancer, and stomach cancer, with higher death rates among members of unskilled manual groups. Associations attenuated after adjustment for adult social class, smoking, and body mass index. No trend was seen for breast cancer or accidents and violence. Adverse social conditions in both childhood and adulthood were associated with higher death rates from coronary heart disease and respiratory disease. Stomach cancer was influenced primarily by childhood conditions and lung cancer by factors in adult life. Conclusions. Socioeconomic position in childhood was associated with adult mortality in a large sample of British women. In several recent studies, low socioeconomic status or position in childhood has been found to increase the risk of certain causes of mortality, particularly cardiovascular disease. 1 Most studies have been limited to male participants and, often, to a restricted range of causes of death. 1 When women have been included in study populations, these populations have contained insufficient numbers of participants to allow examination of several specific causes of death or have lacked information on important adult risk factors such as body mass index (BMI) and smoking behaviors. 2 – 8 We therefore know little about how childhood socioeconomic position affects women’s risk of mortality and whether adverse conditions increase their risk in the same manner as for men. Women are generally neglected in studies of major causes of death, such as coronary heart disease, 9 yet there are several reasons why we cannot assume that the risks are the same for men and women and why studies of women are needed. Associations between mortality and adult social position tend to be weaker among women than among men, 10 , 11 possibly because of gender differences in socioeconomic distributions of exposures, including health-related factors such as tobacco use and obesity. 12 Also, characteristics unique to women that tend to be socially patterned, such as factors related to reproduction, may affect mortality risk. 13 Using data from a large population of British women followed from the beginning of their early adult life, we sought to establish whether childhood socioeconomic position influences risk of mortality separately from the effect of adult socioeconomic position and to determine whether relationships vary according to cause of death.
