The impact of life course socioeconomic status on cardiovascular disease and overall mortality

There is an inverse relationship between socioeconomic status (SES) and health which is consistent across samples and countries. Social inequality in health has been increasing in most of the developing and developed countries. However, the mechanisms linking SES and health are only partially understood, and there have been calls for research using multiple socioeconomic status (SES) assessments at different stages of life course to explicate this relationship. The purpose of this thesis was to examine the interplay between childhood and adult SES and their effects on cardiovascular disease and overall mortality. We investigated three developmental models: stage, cumulative and social mobility. We hypothesized that the cumulative model, or length of exposure to low SES status, would be the best predictor of the health outcomes. To test our hypothesis, we used data from the Normative Aging Study (NAS), a longitudinal study of 98% white men recruited between 1961 and 1970 (study N = 1569). Our sample varied in age between 22 to 64 years old at baseline, and were screened for good health. We assessed both father's and respondent's occupation and education. Outcome measures included cardiovascular diseases and overall mortality, and we controlled for risk factors such as cholesterol, blood pressure, and smoking.;Preliminary models found that the relationship between SES and health varied by type of SES measure. Respondent's education and father's occupation predicted cardiovascular morbidity and respondent's occupation predicted mortality. The effect was non-linear: accelerated mortality was seen in the lowest occupational group. Contrary to expectations, comparison of the three developmental models clearly supported the stage model. Neither the cumulative nor the social mobility models were significant. Instead, we found that lower SES in childhood increased the risk of cardiovascular morbidity, but it was adult SES that predicted mortality.;Even in this highly select sample which received frequent physical exams, we found a significant non-linear relationship between SES and cardiovascular diseases and overall mortality. This relationship was specific to the types of SES assessment and sensitive to the stage of development. Even though childhood SES may constitute a risk factor for adult cardiovascular disease, adult SES may moderate this vulnerability.