Impact of educational attainment on the association between social class at birth and multimorbidity in middle age in the Aberdeen Children of the 1950s cohort study
Impact of educational attainment on the association between social class at birth and multimorbidity in middle age in the Aberdeen Children of the 1950s cohort study
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DOI：
10.1136/bmjopen-2018-024048
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Crilly, Michael A.
中科院分区：
文献类型：
--
作者：
Johnston, Marjorie C.;Black, Corrinda;Crilly, Michael A.
目的多发病（两种或两种以上健康状况并存）日益普遍。没有长期的队列研究探讨了出生社会阶层沿着与教育程度对成人自我报告的多发病率的影响。我们调查的影响，教育程度的社会阶层之间的关系，在出生和成人自我报告的多发病率在阿伯丁儿童的20世纪50年代（ACONF）coherent.Methods一项前瞻性队列研究，使用ACONF队列。ACONF包括12150名1950-1956年出生于苏格兰阿伯丁的人。2001年，7 184人（64%）对问卷作出答复，提供了包括自我报告的发病率和教育程度在内的信息。暴露是父亲的社会阶层在出生时，从出生记录和结果是自我报告的多发病。Logistic回归评估了社会阶层和多发病与性别调整之间的关联，然后是教育程度，最后是儿童认知和中学类型。OR和95%CIs.Results的7184个人（平均年龄48岁，52%女性），5.4%的多发病。出生社会阶层与成人多发性硬化症有关。例如，与参考组（III（手动））相比，最高社会阶层组（I/II）中按性别调整的多死亡的OR为0.62（95% CI 0.39至1.00），最低社会阶层组为1.85（95% CI 1.19至2.88）。这是部分衰减，在所有的社会阶层类别的教育程度，例如，OR为0.74（95%CI 0.45至1.21）在组I/II调整后。这是部分介导的教育程度和未来的研究应考虑确定其他解释变量。这些结果对研究人员和那些旨在减少多Mortocell影响的人都有意义。
Objective Multimorbidity (the coexistence of two or more health conditions) is increasingly prevalent. No long-term cohort study has examined the impact of contemporaneously measured birth social class along with educational attainment on adult self-reported multimorbidity. We investigated the impact of educational attainment on the relationship between social class at birth and adult self-reported multimorbidity in the Aberdeen Children of the 1950s (ACONF) cohort.Methods A prospective cohort study using the ACONF cohort. ACONF included 12150 individuals born in Aberdeen, Scotland 1950-1956. In 2001, 7184 (64%) responded to a questionnaire providing information including self-reported morbidity and educational attainment. The exposure was father's social class at birth from birth records and the outcome was selfreported multimorbidity. Logistic regression assessed the association between social class and multimorbidity with adjustment for gender, then by educational attainment and finally by childhood cognition and secondary school type. ORs and 95% CIs were presented.Results Of 7184 individuals (mean age 48, 52% female), 5.4% reported multimorbidity. Birth social class was associated with adult multimorbidity. For example, the OR of multimorbidity adjusted by gender was 0.62 (95% CI 0.39 to 1.00) in the highest social class group (I/II) in relation to the reference group (III (manual)) and was 1.85 (95% CI 1.19 to 2.88) in the lowest social class group. This was partially attenuated in all social class categories by educational attainment, for example, the OR was 0.74 (95% CI 0.45 to 1.21) in group I/II following adjustment.Conclusion Lower social class at birth was associated with developing multimorbidity in middle age. This was partially mediated by educational attainment and future research should consider identifying the other explanatory variables. The results are relevant to researchers and to those aiming to reduce the impact of multimorbidity.