Influence of early life factors on social inequalities in psychiatric outcomes among young adult Norwegian men

Background: Social inequalities in health can to a substantial degree be explained by social causation. However, indirect selection by early life factors has been suggested. The main aim of this study was to estimate how much adult social gradients in selected psychiatric outcomes depended on parental and individual characteristics in early life. Methods: The population comprised all males born in Norway 1967–71 (n = 170 678). We compiled data on several social and biological variables from birth onwards from different national registers. Health outcomes were collected from the Cause of Death Register (suicide) and the Labour and Welfare Administration (psychiatric disability, psychiatric sickness absence). Indicator of socio-economic position was education level at the age of 28 years. Men were followed up between 4 and 9 years from the age of 29 years. Results: Crude rates per 100 000 person-years were 21.8 (suicide), 145.7 (disability) and 1164.7 (sickness absence). Social inequalities were strong and consistent for all outcomes. Parental and individual characteristics accounted for a substantial part of the social inequalities in neurosis or personality disorder disability (44.1%) and a moderate role for inequalities in psychiatric sickness absence (25.6%), schizophrenia disability (20.7%) and suicide (17.4%). General ability at the age of 18 years had strongest influence on the social health gradients. Suicide and schizophrenia disability were associated with a combination of high parental and low own education level. Conclusion: This study indicates that indirect selection explains a substantial part of social inequalities in certain psychiatric outcomes and that early life prevention is important to reduce health gradients

Yrke og fødsel: En undersøkelse over betydningen av kvinners yrkesaktivitet for opptreden av fosterskader : Occupation and Outcome of Pregnancy

Denne rapporten gjør rede for resultatene fra en undersøkelse om sammenhenger mellom nyfødte barns helsetilstand og mødrenes yrkesforhold. Framstillingen er utarbeidd på grunnlag av en mer omfattende rapport som forelå i desember 1978 fra Hygienisk institutt, Universitetet i Oslo. Undersøkelsen omfatter fødte i perioden 1970-1973 meldt til Medisinsk fødselsregister, Universitetet i Bergen. Opplysninger om yrkesforhold mv. for mødrene er hentet fra folketellingen 1. november 1970 i Statistisk Sentralbyrå. Ansvarlig leder for prosjektet har vært professor dr.med. Tor Bjerkeda

Early life determinants of musculoskeletal sickness absence in a cohort of Norwegians born in 1967-1976

In order to investigate the extent to which musculoskeletal sickness absence was influenced by a range of circumstances concerning family background and health in early life, we established a register-based cohort of all live-born in Norway between 1967 and 1976. Personal data on parental factors and health early in life were recorded prospectively from birth onward in the Medical Birth Registry of Norway, the National Insurance Administration, Statistics Norway, and the Central Population Register. We collected data in the National Insurance Administration on the first spell of medically certified long-term (>16 days) musculoskeletal (International Classification of Primary Care group L) sickness absence in 2000-2003 among 378, 356 participants who were considered to be at risk of sickness absence on January 1st, 2000. The 4-year musculoskeletal absence risk was 0.264 for women and 0.156 for men. Parental education level was associated with musculoskeletal sickness absence, with increasing adjusted relative risks by decreasing educational level for both genders. Associations with other early determinants (birth weight, childhood disease, parental survival, parental disability, parental income, and parental marital status) were all close to unity. Parental education level attributed 36% (95% confidence interval 33-38) to the population risk for women and 67% (64-70) for men. The parental education association was partly mediated through own educational attainment, which was strongly associated with musculoskeletal sickness absence in itself. Our data suggest that mechanisms acting early in life could influence later risk of musculoskeletal sickness absence.Norway Educational status Family characteristics Occupational health Socioeconomic factors Musculoskeletal