Lee Berney

Life course accumulation of disadvantage: childhood health and hazard exposure during adulthood.

The present paper examines the association between physical and social disadvantage during childhood and lifetime exposure to health-damaging environments. Study members were participants of Boyd Orrs clinical, social and dietary survey conducted between 1937 and 1939 and were aged between 5 and 14 years at clinical examination. Study participants were traced and between 1997 and 1998 a random sample of 294 were interviewed. The lifegrid interview method was used to collect full occupational, residential and household histories, from which accumulated lifetime exposures to a range of environmental hazards were estimated. Age-adjusted height during childhood was found to be inversely related to subsequent exposure to all hazards combined (males p = 0.002; females p = 0.001). This relationship was found in males with manual fathers (p = 0.044) and females with non-manual fathers (p = 0.035). Chronic disease during childhood was also associated with greater subsequent hazard exposure in males with manual fathers (p = 0.008). Among females with non-manual fathers, in contrast, chronic disease during childhood was associated with reduced subsequent hazard exposure (p = 0.05). These findings suggest that exposure to health-damaging environments during adulthood may accumulate on top of health disadvantage during childhood and that this process of life course accumulation of disadvantage may vary by gender and childhood social class.

Prepubertal stature and blood pressure in early old age

AIMS To test the hypothesis that childhood growth rate is a marker for formation of control mechanisms that influence blood pressure in early old age. METHODS Data are from a sample of 149 (74 male) members of Sir John Boyd Orrs survey of British families conducted between 1937 and 1939. Measured heights were collected between ages 5 and 8 years, and in early old age between 1997 and 1998. Multiple linear regression investigated the relations of blood pressure with age and sex standardised childhood height with adjustment for potential confounding factors, including adult height. Inclusion of both childhood and adult heights in the same model was used to estimate growth, as measures of childhood height are relative to adult height. RESULTS Mean blood pressures in early old age for those in the shortest childhood height fifth were 167.8 and 76.3 mm Hg for systolic blood pressure and pulse pressure, respectively. For the tallest fifth they were 150.8 and 63.7 mm Hg, respectively. After adjustment for potential confounding factors including adult height, the mean increase for the shortest childhood height fifth compared with the tallest was 28.5 mm Hg for systolic pressure (p = 0.015) and 22.8 mm Hg (p = 0.010) for pulse pressure. The relations of blood pressure with adult height were not statistically significant in the adjusted models. CONCLUSION Prepubertal growth rate is associated with the formation of mechanisms associated with the control of blood pressure in later life.

Domestic labour, paid employment and women's health: analysis of life course data

The relationship between the amount of domestic labour performed by a woman during her lifetime and a variety of self-reported and objective measures of her health in early old age was examined in the female members (n = 155) of a data set containing considerable life course information, including full household, residential and occupational histories. Domestic labour, on its own, proved a weak predictor of health. The relationship strengthened when domestic labour was combined with the hazards of the formal paid employment which the woman had performed. This suggests that it is the combination of domestic labour plus paid employment which influences womens health. The robustness of this conclusion is indicated by its agreement with other studies which reached the same conclusion through an analysis of data with markedly different characteristics.

Socioeconomic measures in early old age as indicators of previous lifetime exposure to environmental health hazards

The relationship between disadvantage in early old age and disadvantage earlier in life was investigated by collecting lifetime residential and occupational histories from 294 subjects aged between 63 and 78 years. Lifetime exposure scores, expressed as the age-adjusted number of years exposed to a range of health hazards, were calculated. Associations between these scores and six measures of socioeconomic position after retirement were examined. Compared with the more advantaged, the more disadvantaged on each post-retirement socioeconomic measure had higher lifetime exposure scores. Mutual adjustment showed that the Registrar Generals (RG) social class, based on the persons own last main occupation, had the strongest association with previous hazard exposure. In the absence of the information required to assign an RG class status, receipt of state welfare benefits in early old age had the strongest association with previous hazard exposure for women, whilst for men, current tenure status was most strongly associated.