Dataset Information

Socioeconomic status and pulmonary function, transition from childhood to adulthood: cross-sectional results from the polish part of the HAPIEE study.

ABSTRACT:

Objective

Previous studies have reported inverse associations between socioeconomic status (SES) and lung function, but less is known about whether pulmonary function is affected by SES changes. We aimed to describe the relationship of changes of SES between childhood and adulthood with pulmonary function.

Design

Cross-sectional study.

Participants

The study sample included 4104 men and women, aged 45-69 years, residents of Krakow, participating in the Polish part of the Health, Alcohol and Psychosocial Factors in Eastern Europe Project.

Main outcome

Forced expiratory volume (FEV₁) and forced vital capacity (FVC) were assessed by the standardised spirometry procedure. Participants were classified into three categories of SES (low, moderate or high) based on information on parent's education, housing standard during childhood, own education, employment status, household amenities and financial status.

Results

The adjusted difference in mean FVC between persons with low and high adulthood SES was 100 mL (p=0.005) in men and 100 mL (p<0.001) in women; the differences in mean FEV₁ were 103 mL (p<0.001) and 80 mL (p<0.001), respectively. Upward social mobility and moderate or high SES at both childhood and adulthood were related to significantly higher FEV₁ and FVC compared with low SES at both childhood and adulthood or downward social mobility.

Conclusions

Low SES over a life course was associated with the lowest lung function. Downward social mobility was associated with a poorer pulmonary function, while upward mobility or life course and moderate or high SES were associated with a better pulmonary function.

SUBMITTER: Polak M

PROVIDER: S-EPMC6340009 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Although the inverse association between socioeconomic status (SES) and cardiovascular disease (CVD) is well established, research on the effect of changes in the SES throughout life on CVD risk in populations with different social backgrounds remains scarce. This study aimed to assess the relationship between childhood SES, adulthood SES, and changes in SES over time, and CVD incidence and mortality in a Polish urban population. In addition, the predictive performance of the SES index was compared with education alone. A cohort study with a 10-year follow-up was conducted, in which a random sample of 10,728 residents in Kraków aged 45–69 years were examined. The SES was assessed at baseline using data on education, parents’ education, housing standard at the age of 10 years, professional activity, household amenities, and difficulties in paying bills and buying food. SES categories (low, middle, and high) were extracted using cluster analyses. Information on new CVD cases was obtained from questionnaires in subsequent phases of the study and confirmed by reviewing clinical records. Data on deaths and causes were obtained from the residents’ registry, Central Statistical Office, and the participants’ families. The effect of the SES index on the risk of CVD was assessed using Cox proportional hazard models. In male and female participants, the CVD incidence and mortality were observed to be 27,703 and 32,956 person-years (384 and 175 new CVD cases) and 36,219 and 40,048 person-years (159 and 92 CVD deaths), respectively. Childhood SES was not associated with CVD incidence and mortality. A protective effect of high adulthood SES against CVD mortality was observed in men and women (HR = 0.59, 95% CI = 0.31–0.97; HR = 0.33, 95% CI = 0.14–0.75, respectively). In women, downward social mobility was related to 2.24 and 3.75 times higher CVD incidence and mortality, respectively. In men, a protective effect against mortality was observed in upward mobility (HR = 0.50, 95% CI = 0.29–0.84). Model discrimination was similar for the SES index and education alone for the association with CVD incidence. In women, the SES index was a slightly better predictor of CVD mortality than education alone (C-index = 0.759, SE = 0.0282 vs. C-index = 0.783, SE = 0.0272; p = 0.041). In conclusion, high adulthood SES, but not childhood SES, may be considered to be a protective factor against CVD in urban populations in high-CVD-risk regions. No effects of critical periods in early life were observed on CVD risk. In later life, social mobility was found to affect CVD mortality in both men and women. In men, a protective effect of upward mobility was confirmed, whereas in women, an increased CVD risk was related to downward mobility. It can be concluded that CVD prevention may be beneficial if socioeconomic potentials are strengthened in later life.

Project description:This is a retrospective cross-sectional study examining the association between unemployment, cancer type, treatment and total body fat percentage of childhood cancer survivors recruited at St. Anne's University Hospital in Brno, Czech Republic. A total of 55 survivors aged 18-49 who were in remission of cancer and fulfilled the criteria for body composition measurements by the BIA and completed questionnaires investigating their socioeconomic status, employment status, and history. There was a significant relationship between the employment status and central nervous system-directed treatment (c2(1) = 7.53, p = 0.006, Cramér's V = 0.38) and between the type of cancer and employment status (c2(3) = 7.83, p = 0.049, Cramér's V = 0.38), the highest unemployment rate was recorded for brain and spine survivors (72.7%) compared to survivors with other diagnosis (35.7%) (uLR(1) = 4.91, p = 0.027; OR = 4.80, 95% CI:1.10-20.86, p = 0.036); these survivors did not have a significantly different body fat percentage compared to survivors with other diagnoses (t(53) = 1.29, p = 0.202, Cohen's d = 0.41) Interestingly, the survivors reporting having a partner also had a significantly higher percentage of body fat (t(53) = 2.90, p = 0.005, Cohen's d = 0.81). A linear regression model was used to model the percentage of body fat in relation to a set of selected variables and the we observed a significant effect of sex (female vs male: b = 6.37, 95% CI: 1.82-10.93, p = 0.007), partnership status (yes vs no: b = 5.65, 95% CI: 0.67-10.62, p = 0.027) and category of diagnosis (Brain and spinal column tumors vs Other solid tumors: b = 12.40, 95% CI: 0.59-24.21, p = 0.040; Brain and spinal column tumors vs Lymphoma: b = 14.02, 95% CI: 2.06-25.97, p = 0.023). Employment status and risk of adiposity in childhood cancer survivors depends on the type of treatment and diagnosis group, which may significantly impact their lifestyle and overall quality of life after treatment. Trial registration: This study was registered on July 29, 2022, at ClinicalTrials.gov (NCT05481229).

Project description:BackgroundCardiovascular health shows significant socioeconomic inequalities, however there is little understanding of the role of early adulthood in generation of these inequalities. We assessed the contribution of socioeconomic trajectories during early adulthood (16-24 years) to cardiovascular health in mid-adulthood (46 years).MethodsParticipants from the 1970 British Cohort Study with socioeconomic data available in early adulthood were included (n=12 423). Longitudinal latent class analysis identified socioeconomic trajectories, based on patterns of economic activity throughout early adulthood. Cardiometabolic risk factors (46 years) were regressed on socioeconomic trajectory class (16-24 years), testing mediation by adult socioeconomic position (46 years). Models were stratified by sex and adjusted for childhood socioeconomic position (SEP) and adolescent health.ResultsSix early adulthood socioeconomic trajectories were identified: (1) Continued Education (20.2%), (2) Managerial Employment (16.0%), (3) Skilled Non-manual Employment (20.9%), (4) Skilled Manual Employment (18.9%), (5) Partly Skilled Employment (15.8%) and (6) Economically Inactive (8.1%). The 'Continued Education' trajectory class showed the best cardiovascular health at age 46 years, with the lowest levels of cardiometabolic risk factors. For example, systolic blood pressure was 128.9 mm Hg (95% CI 127.8 to 130.0) among men in the 'Continued Education' class, compared with 131.3 mm Hg (95% CI 130.4 to 132.2) among men in the 'Skilled Manual' class. Patterns across classes 2-6 differed by risk factor and sex. The observed associations were largely not mediated by SEP at age 46 years.ConclusionFindings suggest an independent contribution of early adulthood socioeconomic trajectories to development of later life cardiovascular inequalities. Further work is needed to understand mediators of this relationship and potential for interventions to mitigate these pathways.

Project description:Importance:Many children in the United States and around the world are exposed to lead, a developmental neurotoxin. The long-term cognitive and socioeconomic consequences of lead exposure are uncertain. Objective:To test the hypothesis that childhood lead exposure is associated with cognitive function and socioeconomic status in adulthood and with changes in IQ and socioeconomic mobility between childhood and midlife. Design, Setting, and Participants:A prospective cohort study based on a population-representative 1972-1973 birth cohort from New Zealand; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years (until December 2012). Exposures:Childhood lead exposure ascertained as blood lead levels measured at age 11 years. High blood lead levels were observed among children from all socioeconomic status levels in this cohort. Main Outcomes and Measures:The IQ (primary outcome) and indexes of Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed (secondary outcomes) were assessed at age 38 years using the Wechsler Adult Intelligence Scale-IV (WAIS-IV; IQ range, 40-160). Socioeconomic status (primary outcome) was assessed at age 38 years using the New Zealand Socioeconomic Index-2006 (NZSEI-06; range, 10 [lowest]-90 [highest]). Results:Of 1037 original participants, 1007 were alive at age 38 years, of whom 565 (56%) had been lead tested at age 11 years (54% male; 93% white). Mean (SD) blood lead level at age 11 years was 10.99 (4.63) µg/dL. Among blood-tested participants included at age 38 years, mean WAIS-IV score was 101.16 (14.82) and mean NZSEI-06 score was 49.75 (17.12). After adjusting for maternal IQ, childhood IQ, and childhood socioeconomic status, each 5-µg/dL higher level of blood lead in childhood was associated with a 1.61-point lower score (95% CI, -2.48 to -0.74) in adult IQ, a 2.07-point lower score (95% CI, -3.14 to -1.01) in perceptual reasoning, and a 1.26-point lower score (95% CI, -2.38 to -0.14) in working memory. Associations of childhood blood lead level with deficits in verbal comprehension and processing speed were not statistically significant. After adjusting for confounders, each 5-µg/dL higher level of blood lead in childhood was associated with a 1.79-unit lower score (95% CI, -3.17 to -0.40) in socioeconomic status. An association between greater blood lead levels and a decline in IQ and socioeconomic status from childhood to adulthood was observed with 40% of the association with downward mobility mediated by cognitive decline from childhood. Conclusions and Relevance:In this cohort born in New Zealand in 1972-1973, childhood lead exposure was associated with lower cognitive function and socioeconomic status at age 38 years and with declines in IQ and with downward social mobility. Childhood lead exposure may have long-term ramifications.

Project description:OBJECTIVES:To determine prevalences of underweight and overweight as well as low and high waist-to-height ratio (WHtR) in three prospective follow-ups and to explore tracking of these measures of nutritional status from childhood to adolescence and adulthood. The influence of socioeconomic status, remoteness, maternal body mass index (BMI) and birth weight on weight status was assessed. DESIGN:Longitudinal birth cohort study of Indigenous Australians. SETTING:Data derived from three follow-ups of the Aboriginal Birth Cohort study with mean ages of 11.4, 18.2 and 25.4 years for the participants. PARTICIPANTS:Of the 686 Indigenous babies recruited to the study between 1987 and 1990, 315 had anthropometric measurements for all three follow-ups and were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES:BMI categories (underweight, normal weight, overweight and obesity),WHtR categories (low and high), sex, areal socioeconomic disadvantage as defined by the Indigenous Relative Socioeconomic Outcomes index, urban/remote residence, maternal BMI and birth weight. Logistic regression was used to calculate ORs for belonging to a certain BMI category in adolescence and adulthood according to BMI category in childhood and adolescence. RESULTS:Underweight was common (38% in childhood and 24% in adulthood) and the prevalence of overweight/obesity increased with age (12% in childhood and 35% in adulthood). Both extremes of weight status as well as low and high WHtR tracked from childhood to adulthood. Underweight was more common and overweight was less common in remote and more disadvantaged areas. Birth weight and maternal BMI were associated with later weight status. There were significant sex differences for prevalences and tracking of WHtR but not for BMI. CONCLUSIONS:Socioeconomic factors, remoteness and gender must be addressed when assessing nutrition-related issues in the Indigenous communities due to the variation in nutritional status and its behaviour over time within the Indigenous population.

Project description:The developmental health of young children is highly influenced by the socioeconomic conditions in which they are raised. How to accurately measure these conditions is a point of debate in the current literature on child development, health, and social determinants. We have evaluated four existing indices of socioeconomic status (SES) to determine the most relevant for the analysis of early childhood development (ECD) in Canada. Following a literature review of published SES indices which used 2006 Canadian Census data, four indices were chosen based on their relevance to ECD and the number of citations in subsequent articles. These were: the Canadian Deprivation Index, the Socioeconomic Factor Index, the Canadian Marginalization Index and an index created by the Early Childhood Mapping Project in Alberta, Canada. The indices were replicated using SES data for 2038 customized geographic neighbourhoods encompassing 99.9% of the Canadian population, and the relationship of the indices to ECD was investigated by linking to aggregated data from the Early Development Instrument (EDI), a teacher-completed questionnaire used to assess kindergarten children's physical, social, emotional, and cognitive development, and communication skills. The derived SES indices were compared based on four criteria: the input variables used, the index structure, the interpretability of the index and the variance they explained (R2) in the different EDI outcome measures. In terms of variance explained, material components of the SES indices (e.g., income, education) consistently showed the strongest association with children's language and cognitive development. The patterns of association for the non-material SES components and the other developmental domains of the EDI were more complex. We discuss the findings in regard to current developments in the field, and the need for refining empirical and theoretical approaches to examine associations between different facets of SES contextual factors and different aspects of ECD outcomes.