<br><span class="gmail_quote">From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>><br>crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="maroon" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: maroon; FONT-FAMILY: Arial">Is the association between childhood socioeconomic circumstances and cause-specific mortality established? <br>
Update of a systematic review</span></font></b></p>
<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><br></span></font></b><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">B Galobardes¹, J W Lynch², G Davey Smith¹ </span></font></p>

<p style="MARGIN-LEFT: 0.5in">^{<font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">1</span></font>}<font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> Department of Social Medicine, University of Bristol, UK <br>
² Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada </span></font></p>
<p style="MARGIN-LEFT: 0.5in"><b><i><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-STYLE: italic; FONT-FAMILY: Arial">Journal of Epidemiology and Community Health</span></font></i></b><b><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> - May 2008 - Volume 62, Number 5</span></font></b></p>

<p style="MARGIN-LEFT: 0.5in"><strong><b><font face="Arial" color="navy" size="2"><span style="FONT-WEIGHT: normal; FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Website: <a onclick="return top.js.OpenExtLink(window,event,this)" href="http://jech.bmj.com/cgi/content/full/62/5/387" target="_blank"><font color="navy"><span style="COLOR: navy">http://jech.bmj.com/cgi/content/full/62/5/387</span></font></a> </span></font></b></strong></p>

<p style="MARGIN-LEFT: 0.5in"><strong><b><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Objective:</span></font></b></strong><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> To update a systematic review on the association between childhoodsocioeconomic circumstances and cause-specific mortality. Studiespublished since 2003 include a far greater number of deathsthan was previously available justifying an update of the previoussystematic review.</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><strong><b><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Methods:</span></font></b></strong><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> Individual-level studies examining childhood socioeconomic circumstancesand adult overall and cause-specific mortality published between2003 and April 2007.</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><strong><b><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Results and conclusions:</span></font></b></strong><font face="Arial" color="navy" size="2"><span style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"> The new studies confirmed that mortality risk for all causeswas higher among those who experienced poorer socioeconomiccircumstances during childhood. As already suggested in theoriginal systematic review, not all causes of death were equallyrelated to childhood socioeconomic circumstances. A greaterproportion of new studies included women and showed that a similarpattern is valid for both genders. In addition, the new studiesshow that this association persists among younger birth cohorts,despite temporal general improvements in childhood conditionsacross successive birth cohorts. The difficulties of establishinga particular life-course model were highlighted</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><b><font face="Arial" color="navy" size="1"><span style="FONT-WEIGHT: bold; FONT-SIZE: 9pt; COLOR: navy; FONT-FAMILY: Arial">What this paper adds</span></font></b><font face="Arial" color="navy" size="1"><span style="FONT-SIZE: 9pt; COLOR: navy; FONT-FAMILY: Arial"></span></font></p>

<p style="MARGIN-LEFT: 0.25in"><font face="Arial" color="navy" size="1"><span style="FONT-SIZE: 9pt; COLOR: navy; FONT-FAMILY: Arial">        - The association between childhood socioeconomiccircumstances and cause-specific mortality is present in menand women.<br>
        - This association persists in younger cohorts despitethem not having been exposed to the same sort of childhood hardshipsas previous cohorts<br>        - Education is an important mediator betweenearly life socioeconomic position and adult mortality</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><font face="Arial" color="navy" size="1"><span style="FONT-SIZE: 9pt; COLOR: navy; FONT-FAMILY: Arial"> <b><span style="FONT-WEIGHT: bold">Policy implications<br></span></b><br>This systematic review provides strongevidence that poor socioeconomic circumstances during childhoodare associated with higher mortality among men and women andthat this association persists among younger cohorts. Tacklinghealth inequalities from the start of life needs to be a policypriority if we are to reduce adult health inequalities.</span></font></p>

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