We aimed to investigate cohort differences in age trajectories of hospitalization due to non-communicable conditions, and if these varied by paternal socioeconomic position. We used the Uppsala Birth Cohort Multigenerational Study-including virtually complete information on medical diagnoses. Our sample constituted 28,448 individuals (103,262 observations). The outcome was five-year prevalence of hospitalization due to major non-communicable conditions in 1989-2008. The exposures were age (19-91), year-of-birth (1915-1929; 1938-1972), gender (man vs woman), and parental socioeconomic position (low, medium, and high). We used multilevel logit models to examine associations between exposures and the hospitalization outcome. Younger cohorts had a higher prevalence of hospitalization at overlapping ages than those born earlier, with inter-cohort differences emerging from early-adulthood and increasing with age. For instance, at age 40 predicted probability of hospitalization increased across birth-cohorts-from 1.2% (born in 1948-52) to 2.0% (born in 1963-67)-whereas at age 50 it was 2.9% for those born in 1938-42 compared with 4.6% among participants born in 1953-57. Those with medium and low socioeconomic position had 13.0% and 20.0% higher odds of experiencing hospitalization during the observation period, respectively-when age, year-of-birth and gender were accounted for. We found that no progress was made in reducing the socioeconomic inequalities in hospitalization across cohorts born between 1915 and 1972. Hence, more effective policies and interventions are needed to reduce the overall burden of morbidity-particularly among the most vulnerable.

Background Social and biological circumstances at birth are established predictors of adult socioeconomic position (SEP). This study aims to assess the trends in these associations across two generations and examine the effects of parental early-life characteristics on descendants' adult SEP.

Methods We studied men and women born in the Uppsala University Hospital 1915-1929 (G1) and their offspring born 1932-1960 (G2). Data were collected in archives and routine registers. Adult SEP was assessed as an aggregate measure combining education and occupation. The exposures were family SEP, mother's marital status, mother's parity, mother's age, standardised birth weight, gestational length and birth multiplicity. Linear regression was used to examine the associations across generations.

Results The difference in adult SEP between low and high family SEP at birth was 15.8 (95% CI: 13.3 to 18.3) percentage points smaller in G2 compared with G1, although a considerable difference was still evident in G2. The associations of adult SEP with small birth weight for gestational age, post-term birth and high parity were stable between the generations: the generational differences in adjusted coefficients were 1.5 (95% CI: -1.1 to 4.1), 0.6 (-1.7 to 2.9) and 1.8 (-0.2 to 3.8) percentage points, respectively. The association between grandparental and grandchildren's SEPs was largely explained by parental socioeconomic conditions. Father's preterm birth was independently associated with offspring's SEP.

Conclusion The stability of the associations between early-life biological disadvantages and adult SEP and the persistent, although attenuated, association between early-life and adult SEPs necessitates increased policy attention to both social and health conditions at birth.

The large-scale international migration in the 21st century has emerged as a major threat to the global health equity movement. Not only has the volume of migration substantially increased but also the patterns of migration have become more complex. This paper began by focusing on the drivers of international migration and how health inequalities are linked to migration. Situating migration within the broader structural contexts, the paper calls for using the unharnessed potential of the intersectionality framework to advance immigrant health research. Despite coming from poorer socioeconomic backgrounds and facing disparities in the host society, the immigrants are often paradoxically shown to be healthier than the native population, although this health advantage diminishes over time. Studies on immigrant health, however, are traditionally informed by the acculturation framework which holds the assimilation of unhealthy lifestyles primarily responsible for immigrant health deterioration, diverting the attention away from the structural factors. Although the alternative structural framework came up with the promise to explore the structural factors, it is criticised for an overwhelming focus on access to healthcare and inadequate attention to institutional and societal contexts. However, the heterogeneity of the immigrant population across multiple dimensions of vulnerability demands a novel approach that can bring to the fore both premigratory and postmigratory contextual factors and adequately capture the picture of immigrant health. The paper concludes by questioning the acculturation perspective and pushing the structural paradigm to embrace the intersectionality framework which has the potential to address a wide range of vulnerabilities that intersect to produce health inequalities among the immigrants.