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Table 2 Role of material, psychosocial and behavioural factors and childhood socioeconomic conditions a in explaining associations of adulthood SEP b with CVD mortality (adjusted for age), among men (n=5395)

From: Socioeconomic inequalities in cardiovascular mortality and the role of childhood socioeconomic conditions and adulthood risk factors: a prospective cohort study with 17-years of follow up

 

Adulthood SEP

 

1- low (n=1270)

2- middle low (n=1795)

3- middle high (n=1088)

4- high (n=1242)

Explanatory modelsc

HR (95% CI)

%attentuationd (95% CI)

HR (95% CI)

%attentuationd (95% CI)

HR (95% CI)

%attentuationd (95% CI)

HR (95% CI)

Died from CVD (n (%))

184 (14.5)

 

156 (8.7)

 

97 (8.9)

 

80 (6.4)

Model 1:

1.84 (1.41-2.39)

 

1.32 (1.01-1.73)

 

1.31 (0.97-1.76)

 

1.00

adulthood SEP

       

Model 2:

1.71 (1.29-2.26)

−15% (−40 to 5)

1.26 (0.95-1.66)

−19% (−120 to 14)

1.27 (0.94-1.71)

−13% (−112 to 29)

1.00

adulthood SEP

+ childhood conditions

       

Model 3:

1.49 (1.12-1.98)

−42% (−73 to −20)

1.16 (0.88-1.54)

−50% (−252 to −7)

1.22 (0.91-1.65)

−29% (−259 to 87)

1.00

adulthood SEP

+ material factorse

       

Model 4:

1.70 (1.30-2.21)

−17% (−39 to −12)

1.28 (0.98-1.68)

−13% (−92 to 9)

1.33 (0.99-1.79)

-

1.00

adulthood SEP

+behavioural factorsf

       

Model 5:

1.76 (1.34-2.29)

−10% (−21 to −1)

1.32 (1.00-1.72)

-

1.32 (0.99-1.78)

-

1.00

adulthood SEP

+psychosocial factorsg

       

Model 6:

1.40 (1.05-1.86)

−52% (−94 to −33)

1.17 (0.88-1.54)

−47% (−249 to −1)

1.26 (0.94-1.71)

−16% (−137 to 46)

1.00

adulthood SEP

+ material + behavioural

+ psychosocial factors

       

Model 7:

1.34 (0.99-1.82)

−60% (−109 to −32)

1.13 (0.85-1.51)

−59% (−291 to −2)

1.24 (0.92-1.68)

−23% (−202 to 64)

1.00

adulthood SEP

+ childhood conditions

+ material + behavioural

+ psychosocial factors

       

Direct contribution of childhood conditions (i.e. independent of adulthood risk factors)

8% (60–52)

 

12% (59–47)

 

7% (23–16)

 

Direct contribution of adulthood risk factors (i.e. independent of childhood conditions)

45% (60–15)

 

40% (59–19)

 

10% (23–13)

 

Indirect contribution of childhood conditions, i.e. via adulthood risk factors

7% (15+52-60)

7% (19+47-59)

6% (13+16-23)

  1. SEP, socioeconomic position; CVD, cardiovascular diseases; HR, hazard ratio; CI, confidence interval; BMI, body mass index (kg/m2).
  2. a Childhood socioeconomic conditions were determined by the occupation of the respondent’s father when the respondent was 12 years of age, with 1=professional, 2=white collar, 3=blue collar.
  3. b Adulthood socioeconomic position was determined by the respondent’s highest attained educational level, with 1= primary, 2= lower secondary, 3= higher secondary, 4=tertiary.
  4. c Only factors that were significantly associated with CVD mortality and unequally distributed across adulthood SEP groups were included in the explanatory models, and all models were adjusted for age.
  5. d The percentages show the reduction in harzard ratio (HR) compared to model 1, per SEP group. For instance, the reduction in the OR for the lowest adulthood SEP group when adding childhood socioeconomic conditions to the first model, is [(1.84-1.71)/(1.84-1.00)]*100 = 15%.
  6. e Material factors: car ownership, housing tenure, and financial problems.
  7. f Behavioural factors: smoking, physical activity.
  8. g Psychosocial factors: marital status, use of sleep/anxiety drugs.
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BMC Public Health

ISSN: 1471-2458

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