his.sePublications
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study
Department of Epidemiology and Public Health, University College London, United Kingdom.
Department of Epidemiology and Public Health, University College London, United Kingdom / School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, United States.
Clinicum, Faculty of Medicine, University of Helsinki, Finland / Department of Public Health, University of Turku, Finland / Centre for Population Health Research, University of Turku, Finland / Turku University Hospital, Finland.
Department of Epidemiology and Public Health, University College London, United Kingdom.
Show others and affiliations
2020 (English)In: The Lancet Public Health, ISSN 2468-2667, Vol. 5, no 3, p. e140-e149Article in journal (Refereed) Published
Abstract [en]

Background: Socioeconomic disadvantage is a risk factor for many diseases. We characterised cascades of these conditions by using a data-driven approach to examine the association between socioeconomic status and temporal sequences in the development of 56 common diseases and health conditions. Methods: In this multi-cohort study, we used data from two Finnish prospective cohort studies: the Health and Social Support study and the Finnish Public Sector study. Our pooled prospective primary analysis data comprised 109 246 Finnish adults aged 17–77 years at study entry. We captured socioeconomic status using area deprivation and education at baseline (1998–2013). Participants were followed up for health conditions diagnosed according to the WHO International Classification of Diseases until 2016 using linkage to national health records. We tested the generalisability of our findings with an independent UK cohort study—the Whitehall II study (9838 people, baseline in 1997, follow-up to 2017)—using a further socioeconomic status indicator, occupational position. Findings: During 1 110 831 person-years at risk, we recorded 245 573 hospitalisations in the Finnish cohorts; the corresponding numbers in the UK study were 60 946 hospitalisations in 186 572 person-years. Across the three socioeconomic position indicators and after adjustment for lifestyle factors, compared with more advantaged groups, low socioeconomic status was associated with increased risk for 18 (32·1%) of the 56 conditions. 16 diseases formed a cascade of inter-related health conditions with a hazard ratio greater than 5. This sequence began with psychiatric disorders, substance abuse, and self-harm, which were associated with later liver and renal diseases, ischaemic heart disease, cerebral infarction, chronic obstructive bronchitis, lung cancer, and dementia. Interpretation: Our findings highlight the importance of mental health and behavioural problems in setting in motion the development of a range of socioeconomically patterned physical illnesses. Policy and health-care practice addressing psychological health issues in social context and early in the life course could be effective strategies for reducing health inequalities. Funding: UK Medical Research Council, US National Institute on Aging, NordForsk, British Heart Foundation, Academy of Finland, and Helsinki Institute of Life Science.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 5, no 3, p. e140-e149
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-18290DOI: 10.1016/S2468-2667(19)30248-8ISI: 000518417000009PubMedID: 32007134Scopus ID: 2-s2.0-85079835161OAI: oai:DiVA.org:his-18290DiVA, id: diva2:1412630
Available from: 2020-03-06 Created: 2020-03-06 Last updated: 2020-03-26Bibliographically approved

Open Access in DiVA

fulltext(791 kB)30 downloads
File information
File name FULLTEXT01.pdfFile size 791 kBChecksum SHA-512
76a4ec0aaf179e88cc2bd2d9818544377f62dcbfac70e3d42b41a461ea29cd70acd8c28178dfca81b8465f6bc57659553252b7374623862b95caaf55d7aab2b3
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records BETA

Suominen, Sakari B.

Search in DiVA

By author/editor
Suominen, Sakari B.
By organisation
School of Health SciencesDigital Health Research (DHEAR)
In the same journal
The Lancet Public Health
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 30 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 48 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf