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Peer status in school and adult disease risk: A 30-year follow-up study of disease-specific morbidity in a Stockholm cohort
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
2009 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 63, no 12, 1028-1034 p.Article in journal (Refereed) Published
Abstract [en]

Background: Children have a social status position of their own, apart from that of the family, that may have an impact on short-term and long-term health. The aim of the present study was to analyse the associations between childhood social status in school (ie, peer status) and disease-specific morbidity in adulthood.

Methods: Data were derived from a longitudinal study using a 1953 cohort born in Stockholm, Sweden: The Stockholm Birth Cohort Study (1953–2003). Peer status was sociometrically assessed in sixth grade (1966). Hazard ratios for adult disease-specific morbidity based on information on inpatient care (1973–2003) were calculated by peer status category for men and women separately, using Cox regression.

Results: The results indicate that the lower the childhood peer status, the higher the overall adult disease risk. There were, however, differences in the degree and magnitude to which disease-specific inpatient care varied with peer status. Some of the steepest gradients were found for mental and behavioural disorders (eg, alcohol abuse and drug dependence), external causes (eg, suicide) and various lifestyle-related diseases (eg, ischaemic heart disease and diabetes). The results were not explained by childhood social class.

Conclusion: The present study underlines the importance of recognising children’s social position, apart from that of their family, for later health. Not only psychologically related diseases but also those related to behavioural risk factors demonstrate some of the largest relative differences by peer status, suggesting that health-related behaviour may be one important mechanism in the association between peer status and morbidity.

Place, publisher, year, edition, pages
2009. Vol. 63, no 12, 1028-1034 p.
National Category
Research subject
URN: urn:nbn:se:su:diva-28361DOI: 10.1136/jech.2009.088377ISI: 000271944700015OAI: diva2:223947
Available from: 2009-06-15 Created: 2009-06-15 Last updated: 2011-03-24Bibliographically approved
In thesis
1. A class of origin: The school class as a social context and health disparities in a life-course perspective
Open this publication in new window or tab >>A class of origin: The school class as a social context and health disparities in a life-course perspective
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of the present thesis is to examine various aspects of the school-class structure and their links to health in a life-course perspective. The empirical studies are based on two longitudinal data materials of cohorts born in the 1950s, followed up until middle age.

In the first study, the overall status distribution in the school class was shown to be associated with both minor psychiatric disorder in childhood and self-rated health in adulthood. Thus, ill-health was more common among individuals who attended school classes less equal in terms of status.

The second study demonstrated that it was more common among those who had fewer mutual friendships in the school class to report poorer health as adults. Socioeconomic career emerged as the primary explanation for men while, for women, these findings were largely unaccounted for by any of the included child and adult circumstances.

Findings from the third study suggested the child’s status position in the school class, i.e. peer status, to be related to a wide range of health outcomes in adulthood. In particular, lower peer status was linked to an excess risk of mental and behavioural disorders, cardiovascular diseases and diabetes. Childhood social class did not confound these associations to any large extent.

The fourth study examined two types of social isolation in the school class: marginalisation (low peer status) and friendlessness. Hospitalisation due to any disease was more common among marginalised children compared to among non-isolates, whereas no corresponding association was found for the friendless. For both types of isolates, the number of hospitalisations was greater than among non-isolated individuals. Of the studied childhood factors, scholastic ability emerged as an important mechanism.

In sum, this thesis points to the relevance of the school class for health development across the life course and to the complexity of pathways through which influences of the school class may operate.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University, 2011. 91 p.
Health Equity Studies, ISSN 1651-5390 ; 16
Children, School class, Social structure, Social networks, Health inequalities, Longitudinal
National Category
Research subject
urn:nbn:se:su:diva-55628 (URN)978-91-7447-246-2 (ISBN)
Public defence
2011-05-20, hörsal 4, hus B, Universitetsvägen 10 B, Stockholm, 13:00 (English)
At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Submitted. Paper 2: Accepted. Available from: 2011-04-28 Created: 2011-03-23 Last updated: 2011-04-08Bibliographically approved

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Almquist, Ylva
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