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Open Access Highly Accessed Research article

Early life socioeconomic adversity is associated in adult life with chronic inflammation, carotid atherosclerosis, poorer lung function and decreased cognitive performance: a cross-sectional, population-based study

Chris J Packard1*, Vladimir Bezlyak2, Jennifer S McLean3, G David Batty4, Ian Ford2, Harry Burns5, Jonathan Cavanagh6, Kevin A Deans7, Marion Henderson8, Agnes McGinty1, Keith Millar6, Naveed Sattar9, Paul G Shiels10, Yoga N Velupillai3 and Carol Tannahill3

Author Affiliations

1 Glasgow Clinical Research Facility, Tennent Building, 38 Church Street, Western Infirmary, Glasgow G11 6NT, UK

2 Robertson Centre for Biostatistics, University of Glasgow, Level 11, Boyd Orr Building, University Avenue, Glasgow G12 8QQ, UK

3 Glasgow Centre for Population Health, 1st Floor, House 6, 94 Elmbank Street, Glasgow G2 4DL, UK

4 Medical Research Council Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ; Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; The George Institute for International Health, Sydney, Australia

5 Scottish Government, St. Andrew's House, Regent Road, Edinburgh EH1 3DG, UK

6 College of Medical, Veterinary and Life Sciences, University of Glasgow: Psychological Medicine, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK

7 NHS Greater Glasgow & Clyde, Glasgow Royal Infirmary, Department of Clinical Biochemistry, Macewen Building, 84 Castle Street, Glasgow G4 0SF; Department of Clinical Biochemistry, First Floor, Link Building, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZD, UK

8 Medical Research Council Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, UK

9 University of Glasgow, Division of Cardiovascular and Medical Sciences, based at Vascular Biochemistry, 4th Floor, Queen Elizabeth Building, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2E, UK

10 University of Glasgow, Faculty of Medicine, University Department of Surgery, Level 2, Queen Elizabeth Building, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK

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BMC Public Health 2011, 11:42  doi:10.1186/1471-2458-11-42

Published: 17 January 2011

Abstract

Background

Socioeconomic gradients in health persist despite public health campaigns and improvements in healthcare. The Psychosocial and Biological Determinants of Ill-health (pSoBid) study was designed to uncover novel biomarkers of chronic disease that may help explain pathways between socioeconomic adversity and poorer physical and mental health.

Methods

We examined links between indicators of early life adversity, possible intermediary phenotypes, and markers of ill health in adult subjects (n = 666) recruited from affluent and deprived areas. Classical and novel risk factors for chronic disease (lung function and atherosclerosis) and for cognitive performance were assessed, and associations sought with early life variables including conditions in the parental home, family size and leg length.

Results

Associations were observed between father's occupation, childhood home status (owner-occupier; overcrowding) and biomarkers of chronic inflammation and endothelial activation in adults (C reactive protein, interleukin 6, intercellular adhesion molecule; P < 0.0001) but not number of siblings and leg length. Lung function (forced expiratory volume in 1 second) and cognition (Choice Reaction Time, the Stroop test, Auditory Verbal Learning Test) were likewise related to early life conditions (P < 0.001). In multivariate models inclusion of inflammatory variables reduced the impact and independence of early life conditions on lung function and measures of cognitive ability. Including variables of adult socioeconomic status attenuated the early life associations with disease biomarkers.

Conclusions

Adverse levels of biomarkers of ill health in adults appear to be influenced by father's occupation and childhood home conditions. Chronic inflammation and endothelial activation may in part act as intermediary phenotypes in this complex relationship. Reducing the 'health divide' requires that these life course determinants are taken into account.