Table 3

Role of material, psychosocial and behavioural factors and childhood socioeconomic conditionsa in explaining associations of adulthood SEPb with CVD mortality (adjusted for age), among women (n=6306)
Adulthood SEP
1- low (n=1961) 2- middle low (n=3079 3- middle high (n=774) 4-high (n=492)
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 (%)) 187 (9.5) 140 (4.5) 38 (4.9) 14 (2.8)
Model 1: 1.80 (1.04-3.10) 1.39 (0.80-2.41) 1.42 (0.77-2.62) 1.00
adulthood SEP
Model 2: 1.71 (0.97-3.01) −11% (−74 to 31) 1.37 (0.78-2.41) −5% (−132 to 102) 1.42 (0.77-2.64) - 1.00
adulthood SEP
+ childhood conditions
Model 3: 1.50 (0.86-2.62) −38% (−135 to −13) 1.24 (0.71-2.16) −38% (−284 to 233) 1.34 (0.73-2.49) −19% (−128 to 116) 1.00
adulthood SEP
+ material factorse
Model 4: 1.36 (0.78-2.38) −55% (−191 to −28) 1.20 (0.69-2.09) −49% (−414 to 244) 1.35 (0.73-2.50) −17% (−167 to 113) 1.00
adulthood SEP
+behavioural factorsf
Model 5: 1.75 (1.00-3.04) −6% (−38 to 21) 1.38 (0.79-2.41) −3% (−74 to 121) 1.40 (0.76-2.59) −5% (−65 to 55) 1.00
adulthood SEP
+psychosocial factorsg
Model 6: 1.22 (0.69-2.18) −73% (−230 to −34) 1.13 (0.64-1.99) −67% (−619 to 235) 1.29 (0.70-2.40) −31% (−230 to 139) 1.00
adulthood SEP
+ material + behavioural
+ psychosocial factors
Model 7: 1.19 (0.66-2.15) −76% (−232 to −29) 1.12 (0.63-2.02) −69% (−446 to 468) 1.29 (0.71-2.47) −31% (−230 to 294) 1.00
adulthood SEP
+ childhood conditions
+ material + behavioural
+ psychosocial factors
Direct contribution of childhood conditions (i.e. independent of adulthood risk factors) 3% (76–73) 2% (69–67) 0% (31–31)
Direct contribution of adulthood risk factors (i.e. independent of childhood conditions) 65% (76–11) 64% (69–5) 31% (24–0)
Indirect contribution of childhood conditions, i.e. via adulthood risk factors 8% (11+73-76) 3% (5+67-69) 0% (0+31-31)

SEP, socioeconomic position; CVD, cardiovascular diseases; HR, hazard ratio; CI, confidence interval; BMI, body mass index (kg/m2).

a Childhood socioeconomic conditions was 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.

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.

c Only factors that were significantly associated with CVD mortality and unequally distributed across adulthood SEP groups were included in the explanatory models. All models were adjusted for age.

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 SEP to the first model, is [(1.80-1.71)/(1.80-1.00)] * 100 = 11%.

e Material factors: housing tenure, and financial problems.

f Behavioural factors: smoking, physical activity, alcohol consumption, BMI.

g Psychosocial factors: marital status.

Kamphuis et al.

Kamphuis et al. BMC Public Health 2012 12:1045   doi:10.1186/1471-2458-12-1045

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