Population surveys were conducted, examining nonpsychotic psychiatric symptoms, life events, and problems in community living in Primrose, a community experiencing rapid growth in anticipation of the construction of a heavy oil extraction plant, and in Wolf Creek, a stable rural town. Psychiatric symptom levels were lower in the boom town than in Wolf Creek, but the Primrose symptom levels were comparable to those in Saskatchewan. More life events were experienced by Primrose residents who, despite lower symptom levels, had seen their physician more often for minor illnesses. The complaints about living in the town of Primrose matched those of boom town residents from elsewhere. There was no evidence to support the popular view that living in a boom town creates more nonpsychotic psychiatric symptomatology. The higher proportion of the boom town population using physician services for minor illnesses, the higher level of life events reported, and the high frequency of reported problems for families living in the boom town support suggestions that stress is associated with these conditions.
BACKGROUND: The Nordic countries, profiled as welfare states, are shown to have comparatively large relative socio-economic differences in mortality and comparatively high intergenerational mobility. The aim of this study was to analyse the role of risk indicator-associated social mobility (from childhood through to adulthood) in socio-economic mortality differences among Swedish men aged 35-50 years. METHODS: We used data on risk indicators for adult mortality (risk use of alcohol, smoking, low emotional control, psychiatric diagnosis, medication for nervous problems, contact with police and child care, experience of unemployment, low body height, low education) collected at compulsory conscription for military training among Swedish men at aged 18-20, fathers' socio-economic status at subjects' ages 9-11 years, data on subjects' socio-economic status at ages 34-36 years, and follow-up data on mortality during 1986-1999 (at ages 35-50 years). RESULTS: Persons in manual occupations in 1985 showed an elevated relative risk (RR) of mortality compared with stable non-manual employees regardless of the social position of their father (RR 1.75 among stable manual workers, and RR 1.74 among the downwardly mobile). In multivariate analyses, taking into account the risk indicators first operating in late adolescence, the increased mortality risk among stable manual workers and also among the downwardly mobile diminished considerably (RR 1.32 and 1.39, respectively). CONCLUSIONS: These results suggest that a substantial part of the socio-economic differences in mortality among middle-aged men had their origin in childhood circumstances. Risk indicator-associated social mobility was found to contribute substantially to an increase in the relative difference in mortality between male manual workers and non-manual employees.
Can we disentangle life course processes of accumulation, critical period and social mobility? An analysis of disadvantaged socio-economic positions and myocardial infarction in the Stockholm Heart Epidemiology Program.
The accumulation hypothesis would propose that the longer the duration of exposure to disadvantaged socio-economic position, the greater the risk of myocardial infarction. However there may be a danger of confounding between accumulation and possibly more complex combinations of critical periods of exposure and social mobility. The objective of this paper is to investigate the possibility of distinguishing between these alternatives. We used a population based case-control study (Stockholm Heart Epidemiology Programme) of all incident first events of myocardial infarction among men and women, living in the Stockholm region 1992-94. The analyses were restricted to men 53-70 years, 511 cases and 716 controls. From a full occupational history each subject was categorized as manual worker or non-manual at three stages of the life course, childhood (from parent's occupation), at the ages 25-29 and 51-55, resulting in 8 possible socio-economic trajectories. We found a graded response to the accumulation of disadvantaged socio-economic positions over the life course. However, we also found evidence for effects of critical periods and of social mobility. A conceptual analysis showed that there are, for theoretical reasons, only a limited number of trajectories available, too small to form distinct empirical categories of each hypothesis. The empirical task of disentangling the life course hypotheses of critical period, social mobility and accumulation is therefore comparable to the problem of separating age, period, and cohort effects. Accordingly, the interpretation must depend on prior knowledge of more specific causal mechanisms.
Low back pain (LBP) is a prevalent problem and tends to be socio-economically patterned. Relatively little is known about life-course socio-economic circumstances as determinants of different types of LBP. Our aim was to examine whether childhood and adult socio-economic position and social mobility are associated with radiating and non-specific LBP and sciatica.
Data were derived from the Young Finns Study (n = 2231). Childhood socio-economic position was based on parental education, occupational class and family income at baseline in 1980. Data on own education and LBP outcomes were collected at the end of follow-up in 2007. Social mobility was based on parental and own education. Covariates were composed of age, parental body mass index and smoking.
Both childhood and own socio-economic position remained associated with radiating LBP and sciatica after adjustments. However, the associations varied by socio-economic indicator and gender. Stable lower socio-economic position and downward mobility were associated with radiating LBP.
Childhood socio-economic circumstances affect the risk of radiating LBP and sciatica in adulthood. To prevent low back disorders, early socio-economic circumstances need to be considered alongside own socio-economic position.
Research has suggested that social-class differences in adult health may be at least partly determined by conditions earlier in life. In 2636 Finnish men, we assessed impact of childhood and adult socioeconomic conditions on adult mortality risk by examining whether differing socioeconomic life-courses from early childhood to adulthood were associated with different risks of all-cause and cardiovascular mortality. Compared with high-income adults, those with low income had increased relative risks of all-cause (2.54, 95% CI 1.83-3.53) and cardiovascular (2.37, 1.51-3.7) mortality, but these increased risks were not related in either adult group to childhood socioeconomic conditions. Men who went from low-income childhood to high-income adulthood had the same mortality risks as those whose socioeconomic circumstances were good in both childhood and adulthood (1.14, 0.56-2.31, all causes; 0.99, 0.39-2.51, cardiovascular). By contrast, men who experienced poor socioeconomic circumstances as both children and adults were about twice as likely to die as those whose position improved (2.39, 1.28-4.44, all causes; 2.02, 0.9-4.54, cardiovascular). Our findings suggest that socioeconomic conditions in childhood are not important determinants of adult health. We caution against this interpretation--a life-course approach to socioeconomic differences in adult health requires understanding of the social and economic context in which individual life-courses are determined.
Comment In: Lancet. 1994 Feb 26;343(8896):4967906754
Comment In: Lancet. 1994 May 14;343(8907):1224-57909885
STUDY OBJECTIVE--The aim was to examine whether body height is associated with intergenerational social mobility, and to determine the importance of intergenerational mobility for adult health. DESIGN--Information from a survey conducted by Statistics Sweden on a randomly selected sample was supplemented with mortality data during a six year follow up. PARTICIPANTS--The sample was identified in 1980-81 and comprised 14,757 persons aged 16-74 years. The non-response rate was 14%. In the current study a subsample of 9203 persons aged 30-74 years at the time of the interview was used. MEASUREMENTS AND MAIN RESULTS--Information on adult height, socioeconomic status during childhood and in adult life, self perceived general health, and self reported longstanding illness at the time of the interview was supplemented with mortality data during the follow up period. The direction of the intergenerational mobility was defined as upward mobility, downward mobility, and no intergenerational mobility. The chances of falling into each of these three groups for tall, medium, and short persons were compared. The three mobility groups were also compared with regard to general health, longstanding illness and early death. The tall third of the sample was upwardly mobile to a larger extent than the short third, while the short third was more likely to be downwardly mobile. The upwardly mobile group perceived their health as bad much less than was expected. It also included a smaller number of persons with longstanding illness. Mortality, however, was not lower in this group. CONCLUSIONS--Childhood environment influences height, height is linked to upward mobility, and upward mobility is linked to better health. This is one way in which childhood environment has an impact on adult health.
The purpose of this study was to analyse the relationships between status incongruency and mortality. From the concept of status incongruence two incongruent groups were defined, those with high education and low social position (socially downward drifters) and those with low education and high social position (socially upstarters). A cohort of middle-aged men (n = 855), all born in 1913 and living in the city of Gothenburg, Sweden were followed during a period of 22 years. The socially downward drifters had a significantly increased risk for: non-cause specific (overall) mortality, more potential years of life lost and mortality caused by coronary heart disease. These differences were still evident after taking other risk factors into account. The socially upstarters had, on the other hand, lower mortality risks and win years. Imbalance between educational level and attained social position appears to affect survival in a long term follow-up.