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Early-life and adult socioeconomic determinants of myocardial infarction incidence and fatality

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  • Kilpi, Fanny
  • Silventoinen, Karri
  • Konttinen, Hanna
  • Martikainen, Pekka

Abstract

Social inequalities in coronary heart disease mortality have roots in childhood conditions, but it is unknown whether they are associated both with the incidence of the disease and the following survival. We studied how several different early-life socioeconomic factors, together with later socioeconomic attainment, were associated with myocardial infarction (MI) incidence and fatality in Finland. The data was based on a register-based sample of households from a census in 1950 that also provided information on childhood circumstances. MI hospitalizations and mortality in 1988–2010 were studied in those who were up to 14 years of age at the time of the census and resident in Finland in 1987 (n = 94,501). Parental education, occupation, household crowding, home ownership, and family type were examined together with adulthood education and income. Hazard and odds ratios with 95% confidence intervals (CI) were calculated using Cox regression (incidence and long-term fatality) and logistic regression (short-term fatality) models. Lower parental education, occupational background and greater household crowding were associated with MI incidence. In models adjusted for adulthood variables, crowding increased the risk by 16% (95% CI 5–29%) in men and 25% (95% CI 3–50%) in women. Short-term survival was more favourable in sons of white-collar parents and daughters of owner-occupied households, but most aspects of childhood circumstances did not strongly influence long-term fatality risk. Socioeconomic attainment in adulthood accounted for a substantial part of the effects of childhood conditions, but the measured childhood factors explained little of the disparities by adulthood education and income. Moreover, income and education remained associated with MI incidence when adjusted for unobserved shared family factors in siblings. Though social and economic development in society seems to have mitigated the disease burden associated with poor childhood living conditions in Finland, low adult socioeconomic resources have remained a strong determinant of MI incidence and fatality.

Suggested Citation

  • Kilpi, Fanny & Silventoinen, Karri & Konttinen, Hanna & Martikainen, Pekka, 2017. "Early-life and adult socioeconomic determinants of myocardial infarction incidence and fatality," Social Science & Medicine, Elsevier, vol. 177(C), pages 100-109.
    • Handle: RePEc:eee:socmed:v:177:y:2017:i:c:p:100-109
    DOI: 10.1016/j.socscimed.2017.01.055
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    References listed on IDEAS

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    1. Elo, Irma T. & Martikainen, Pekka & Myrskylä, Mikko, 2014. "Socioeconomic status across the life course and all-cause and cause-specific mortality in Finland," Social Science & Medicine, Elsevier, vol. 119(C), pages 198-206.
    2. Notkola, V. & Punsar, S. & Karvonen, M. J. & Haapakoski, J., 1985. "Socio-economic conditions in childhood and mortality and morbidity caused by coronary heart disease in adulthood in rural Finland," Social Science & Medicine, Elsevier, vol. 21(5), pages 517-523, January.
    3. Pensola, Tiina & Martikainen, Pekka, 2004. "Life-course experiences and mortality by adult social class among young men," Social Science & Medicine, Elsevier, vol. 58(11), pages 2149-2170, June.
    4. Mark Hayward & Bridget Gorman, 2004. "The long arm of childhood: The influence of early-life social conditions on men’s mortality," Demography, Springer;Population Association of America (PAA), vol. 41(1), pages 87-107, February.
    5. Dowd, Jennifer Beam & Zajacova, Anna & Aiello, Allison, 2009. "Early origins of health disparities: Burden of infection, health, and socioeconomic status in U.S. children," Social Science & Medicine, Elsevier, vol. 68(4), pages 699-707, February.
    6. Madsen, Mia & Andersen, Per K. & Gerster, Mette & Andersen, Anne-Marie N. & Christensen, Kaare & Osler, Merete, 2014. "Are the educational differences in incidence of cardiovascular disease explained by underlying familial factors? A twin study," Social Science & Medicine, Elsevier, vol. 118(C), pages 182-190.
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    1. Aino Salonsalmi & Elina Mauramo & Eero Lahelma & Ossi Rahkonen & Olli Pietiläinen, 2021. "Multiple Socioeconomic Circumstances and Initiation of Cardiovascular Medication among Ageing Employees," IJERPH, MDPI, vol. 18(19), pages 1-13, September.
    2. Magdalena Kozela & Maciej Polak & Urszula Stepaniak & Martin Bobak & Andrzej Pająk, 2022. "Changes in Socioeconomic Status as Predictors of Cardiovascular Disease Incidence and Mortality: A 10-Year Follow-Up of a Polish-Population-Based HAPIEE Cohort," IJERPH, MDPI, vol. 19(22), pages 1-11, November.

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