Key result
Continued education links to ~2.4 mm Hg lower SBP at age 46 versus skilled manual class.
Why the study?
Cardiovascular health shows significant socioeconomic inequalities, but the role of early adulthood in generating these inequalities is poorly understood.
Do early adulthood socioeconomic trajectories affect cardiometabolic risk factors in mid-adulthood?
Cohort (n=12,423)
Do early adulthood socioeconomic trajectories affect cardiometabolic risk factors in mid-adulthood?
Absolute Event Rate: 128.9% vs 131.3%
Early adulthood socioeconomic trajectories independently contribute to the development of cardiovascular health inequalities in later life.
Early education trajectories link to midlife SBP differences in observational data; leaves open whether targeting them alters cardiometabolic risk.
BACKGROUND: Cardiovascular health shows significant socioeconomic inequalities, however there is little understanding of the role of early adulthood in generation of these inequalities. We assessed the contribution of socioeconomic trajectories during early adulthood (16-24 years) to cardiovascular health in mid-adulthood (46 years). METHODS: Participants from the 1970 British Cohort Study with socioeconomic data available in early adulthood were included (n=12 423). Longitudinal latent class analysis identified socioeconomic trajectories, based on patterns of economic activity throughout early adulthood. Cardiometabolic risk factors (46 years) were regressed on socioeconomic trajectory class (16-24 years), testing mediation by adult socioeconomic position (46 years). Models were stratified by sex and adjusted for childhood socioeconomic position (SEP) and adolescent health. RESULTS: Six early adulthood socioeconomic trajectories were identified: (1) Continued Education (20.2%), (2) Managerial Employment (16.0%), (3) Skilled Non-manual Employment (20.9%), (4) Skilled Manual Employment (18.9%), (5) Partly Skilled Employment (15.8%) and (6) Economically Inactive (8.1%). The 'Continued Education' trajectory class showed the best cardiovascular health at age 46 years, with the lowest levels of cardiometabolic risk factors. For example, systolic blood pressure was 128.9 mm Hg (95% CI 127.8 to 130.0) among men in the 'Continued Education' class, compared with 131.3 mm Hg (95% CI 130.4 to 132.2) among men in the 'Skilled Manual' class. Patterns across classes 2-6 differed by risk factor and sex. The observed associations were largely not mediated by SEP at age 46 years. CONCLUSION: Findings suggest an independent contribution of early adulthood socioeconomic trajectories to development of later life cardiovascular inequalities. Further work is needed to understand mediators of this relationship and potential for interventions to mitigate these pathways.
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Winpenny et al. (2021) conducted a cohort in Cardiovascular health (n=12,423). Early adulthood socioeconomic trajectories (e.g., Continued Education) vs. Other socioeconomic trajectories (e.g., Skilled Manual Employment) was evaluated on Cardiometabolic risk factors at age 46 years (e.g., systolic blood pressure). The 'Continued Education' trajectory in early adulthood was associated with lower systolic blood pressure at age 46 compared to the 'Skilled Manual' class (128.9 vs 131.3 mm Hg).
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