Using genetic data to better understand effects of socioeconomic and cognitive factors on health and health inequalities

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Background:Much research has suggested that longstanding health inequalities relating to a range of health outcomes exist, with health typically improving as socioeconomic position (SEP) rises. Many countries and transnational governmental organisations have made the reduction of socioeconomic inequalities in health an explicit aim of health policies. To reduce such inequalities and inform reduction initiatives and policies, robust evidence on the associations between socioeconomic factors and multiple health outcomes is needed. However, causal inferences are difficult to make empirically, with existing observational studies subjected to reverse causality and unobserved confounding bias. Apart from socioeconomic factors, existing studies have also suggested an association between cognitive factors and health. Higher cognitive test scores in childhood were found to be associated with better subsequent health, and several potential mechanisms have been suggested to explain this association. Moreover, cognition and SEP are strongly associated across the life course. However, the independent effects of cognition on health and the causal direction of cognition and SEP with subsequent health outcomes remains unclear, as most existing studies have focused on investigating the effects of SEP and cognition separately. Aims and methods:The main aim of this project is to investigate the effects of socioeconomic and cognitive factors on health and health inequalities in the UK, using new descriptive and causal estimation analyses. The project will use data from the UK birth cohorts (1946; 1958; 1970; 2001 cohort), which allows cross-cohort comparison and patterns of association over time to be analysed. To strengthen evidence on establishing causal relationships, both regression analyses and Mendelian randomisation (MR) will be used. By using MR, the genetically-attributable effects of socioeconomic and cognitive factors on health outcomes will be investigated and stronger evidence on causal inference can be made. A multi-outcome approach will be used, which can investigate the effects of SEP and cognition on multiple health outcomes simultaneously and disentangle the potentially different effects on different health outcomes. Previous rotation work on type of education and subsequent health will be incorporated as a chapter of this full project.