Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Early life socioeconomic position and mortality from cardiovascular diseases: an application of causal mediation analysis in the Stockholm Public Health Cohort.
Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.ORCID iD: 0000-0002-7034-1922
2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 6, article id e026258Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: We aimed to quantify the mediating impact of adult social and behavioural mechanisms in the association between childhood socioeconomic position (SEP) and cardiovascular disease (CVD) mortality by employing a weighting approach to mediation analysis.

DESIGN: Prospective cohort study.

SETTING: Stockholm County, Sweden.

PARTICIPANTS: 19 720 individuals who participated in the Stockholm Public Health Cohort survey in 2002 and were older than 40 years.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was CVD mortality. Non-CVD mortality was additionally analysed for comparison.

METHODS: Study subjects were followed in routine registers from 2002 to 2011 for mortality. Data on father's SEP and adult social and behavioural factors came from questionnaire survey. The inverse odds weighting method was used to estimate the total effect, the natural direct effect and the natural indirect effect (NIE) in Poisson regression models. All results were adjusted for gender, age, country of birth and marital status. Multiple imputation was used to handle missing data.

RESULTS: The total effect of manual versus non-manual father's SEP on CVD mortality was estimated as an incidence rate ratio (IRR) of 1.24 (95% CI 1.09 to 1.41). When the social and behavioural factors were accounted for, the IRR for the NIE was 1.09 (95% CI 1.04 to 1.14), suggesting a mediation of 44% of the total effect. As for non-CVD mortality, father's manual SEP was associated with 1.15 fold excess risk (IRR: 1.15; 95% CI 1.04 to 1.27) of which the effect represented by the whole set of mediators was 1.06 (95% CI 1.01 to 1.10).

CONCLUSION: Adult social and behavioural factors had a considerable mediating effect on the early life social origin of mortality from CVDs and other causes. Future research employing causal mediation analysis may nevertheless have to consider additional factors for a fuller understanding of the mechanisms.

Place, publisher, year, edition, pages
2019. Vol. 9, no 6, article id e026258
Keywords [en]
cardiac epidemiology, epidemiology, public health, social medicine
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:su:diva-178093DOI: 10.1136/bmjopen-2018-026258PubMedID: 31209086OAI: oai:DiVA.org:su-178093DiVA, id: diva2:1386607
Available from: 2020-01-18 Created: 2020-01-18 Last updated: 2020-01-18Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Koupil, Ilona
By organisation
Department of Public Health Sciences
In the same journal
BMJ Open
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 2 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf