Lawlor Debbie A, Ronalds Georgina, Macintyre Sally, Clark Heather, Leon David A
Department of Social Medicine, University of Bristol, Bristol, United Kingdom.
Am J Public Health. 2006 Jul;96(7):1271-7. doi: 10.2105/AJPH.2005.066290. Epub 2006 May 30.
We assessed the association of father's social class, recorded at the time of birth, with coronary heart disease and stroke in a British cohort of 11106 individuals born in the 1950s.
Survival analysis was used to relate social class at birth to the occurrence of either fatal or nonfatal coronary heart disease or stroke.
Rates of coronary heart disease and stroke increased across the social class distribution from highest to lowest, and patterns of association were similar for the 2 outcomes. The gender-adjusted hazard ratio of experiencing either coronary heart disease or stroke comparing the manual and nonmanual social class categories was 1.52 (95% confidence interval [CI]=1.14, 2.02). This ratio fell to 1.41 (95% CI = 1.05, 1.88) after adjustment for indicators of intrauterine and childhood growth. Further adjustment for educational attainment reduced the ratio to 1.28 (95% CI=0.94, 1.75).
We found that social class at birth was associated with risk of fatal and nonfatal cardiovascular disease among individuals born in the 1950s, a period of relative prosperity and after the introduction of the welfare state in Britain. This relation appeared to be mediated in part through educational attainment.
我们评估了20世纪50年代出生的11106名英国队列研究对象出生时记录的父亲社会阶层与冠心病和中风之间的关联。
采用生存分析方法来研究出生时的社会阶层与致命性或非致命性冠心病或中风发生情况之间的关系。
冠心病和中风的发病率在社会阶层分布中从最高到最低逐渐上升，两种结局的关联模式相似。比较体力劳动者和非体力劳动者社会阶层类别，发生冠心病或中风的性别调整风险比为1.52（95%置信区间[CI]=1.14, 2.02）。在对宫内和儿童期生长指标进行调整后，该比值降至1.41（95% CI = 1.05, 1.88）。进一步对教育程度进行调整后，该比值降至1.28（95% CI=0.94, 1.75）。
我们发现，在英国相对繁荣且福利国家制度建立后的20世纪50年代出生的人群中，出生时的社会阶层与致命性和非致命性心血管疾病风险相关。这种关系似乎部分是通过教育程度介导的。
