Childhood circumstances linked to health in later life

Poor social circumstances in adulthood have been known for some time to increase heart disease risk but less attention has been paid to earlier life circumstances. A study in this week’s BMJ finds that adverse social circumstances in childhood, as well as adulthood, are strongly associated with increased risk of insulin resistance, and other heart disease risk factors.

Most people know that the hormone insulin is important for health. But the commonest type of diabetes (type 2 diabetes), which affects about 4% of the British public, occurs because these people are resistant to the action of insulin.

Researchers at the University of Bristol investigated the associations between social class in childhood and adulthood and insulin resistance in over 4,000 women aged 60-79 years.

They found that belonging to a manual social class in childhood and in adulthood was associated with increased insulin resistance, dyslipidaemia, and obesity. The association between childhood social class and insulin resistance was stronger than that between adult social class and insulin resistance.

Women who were in manual social classes as children were still at increased risk of insulin resistance and other risk factors as adults even if they had moved up into non-manual social classes as adults. Childhood factors such as poor nutrition are the most likely reasons for these findings.

The results support the idea that poor social circumstances in childhood lead to insulin resistance, with these risk factors tracking through childhood resulting in increased risk of cardiovascular disease in later life.

These findings highlight the importance of a life course approach to the prevention of cardiovascular disease and reducing socioeconomic inequalities in cardiovascular disease, they conclude.