Journal of Epidemiology and Community Health

BackgroundPublic health research and prevention policies often use the small area Index of Multiple Deprivation (IMD) at neighbourhood level to proxy individual socio-economic status because it is readily available. We investigated what household income adds to IMD in early childhood for predicting adverse health in adolescence. MethodsUsing data from the Millennium Cohort Study, we analysed IMD and self-reported equivalised household income (ages 0-5) to predict outcomes at age 17: poor academ...

ObjectivesThe aim of this analysis is to identify and report the patterns of social deprivation in relation to childhood mortality; and identify potential points where public health, social and education interventions or health policy may be best targeted. DesignDecile of deprivation and underlying population distribution was derived using Office for National Statistics (ONS) data. The risk of death was then derived using a Poisson regression model, calculating the increasing risk of death for ...

BackgroundThe coronavirus (COVID-19) pandemic and consequent physical distancing measures are expected to have far-reaching consequences on population health, particularly in already disadvantaged groups. These consequences include changes in health impacting behaviours (such as exercise, sleep, diet and alcohol use) which are arguably important drivers of health inequalities. We sought to add to the rapidly developing empirical evidence base investigating the impacts of the pandemic on such beh...

IntroductionDisadvantaged socioeconomic position (SEP) in early and adult life has been repeatedly associated with premature mortality. However, it is unclear whether these inequalities differ across time, nor if they are consistent across different SEP indicators. MethodsBritish birth cohorts born in 1946, 1958 and 1970 were used, and multiple SEP indicators in early and adult life were examined. Deaths were identified via national statistics or notifications. Cox proportional hazard models we...

BackgroundEarly childhood poverty is associated with poorer health and educational outcomes in adolescence. However, there is limited evidence about the clustering of these adverse outcomes by income group. MethodsWe analysed five outcomes at age 17 known to limit life chances - psychological distress, self-assessed ill health, smoking, obesity, and poor educational achievement - using data from the longitudinal UK Millennium Cohort Study (N=15,245). We compared how single and multiple outcomes...

BackgroundWe examined long-term trajectories of mental (ill-)health in two British generations ( Baby boomers and Generation X) across the life-course, including the COVID-19 lockdowns and the following cost-of-living increases. We analysed inequalities by generation, gender, socioeconomic position (SEP), and their intersections, and explored the relationship between inflation and mental (ill-)health post-lockdown. Methods and FindingsWe used data from the National Child Development Study (NCD...

ObjectiveTo estimate multimorbidity trajectories and quantify socioeconomic inequalities based on both childhood and adulthood socioeconomic position in the risks and rates of adult multimorbidity accumulation. DesignProspective longitudinal national birth cohort study. MethodsParticipants from the 1946 National Survey of Health and Development (NSHD) who attended the age 36 assessment in 1982 and any one of the follow-up assessments at ages 43, 53, 63 & 69 (N=3,723, 51% males). Information on...

ObjectiveTo examine the association between childhood health and adult health outcomes. MethodsWe used data from the 1970 British Cohort Study, which follows participants from age 10 to age 51. Childhood health at age 10 was measured using the Rutter Scale for emotional and behavioural difficulties and self-reported physical health problems that occurred within the last 12 months. We estimated associations using logistic regression models, applying inverse probability weighting to adjust for sa...

BackgroundInteractions with secondary care, including multiple outpatient appointments and hospital admissions, represents a common and often burdensome aspect of healthcare utilisation for people living with multiple long-term conditions. Lifecourse factors such as education and academic ability may play a role in shaping the risk of healthcare utilisation later in adulthood. We explored the association between education and academic ability in childhood and both outpatient appointments and hos...

BackgroundLife expectancy improved dramatically during the 20th century. Whether more recent generations are also living longer in good health has serious implications for healthcare systems and the economy. AimTo synthesise evidence on cohort differences in physical and mental health from the British birth cohort studies, born 1946 to 2000-02. MethodElectronic databases (MEDLINE, EMBASE, PsycInfo, Web of Science, up to 25 June 2024) were searched for pairwise combinations of the six cohort st...

BackgroundDuring the COVID-19 pandemic children and young people (CYP) mortality in England reduced to the lowest on record, but it is unclear if the mechanisms which facilitated a reduction in mortality had a longer lasting impact, and what impact the pandemic, and its social restrictions, have had on deaths with longer latencies (e.g. malignancies). The aim of this analysis was to quantify the relative risk of childhood deaths, in England, before, during, and after the COVID pandemic and its s...

ObjectiveTo estimate the risk of Long COVID by socioeconomic deprivation and to further examine the socioeconomic inequalities in Long COVID by sex and occupational groups. DesignWe analysed data from the COVID-19 Infection Survey conducted by the Office for National Statistics between 26/04/2020 and 31/01/2022. This is the largest and nationally representative survey of COVID-19 in the UK and provides uniquely rich, contemporaneous, and longitudinal data on occupation, health status, COVID-19 ...

ObjectivesTo examine if there is an association between childhood public care and adverse life outcomes in middle-age. MethodsWe used data from the United Kingdom 1958 birth cohort study of 18,558 babies. Parents of study members were surveyed at age 7, 11, and 16 years when experience of public care of their offspring was ascertained. An array of outcomes were self-reported by cohort members at age 42 years, and a cognitive test battery was administered at age 50. Results420 (3.8%) of 11,160 ...

BackgroundYoung people who are not in education, employment or training (NEET) are at an increased risk of long-term social and economic disadvantage. While previous research has linked various risk factors and individual characteristics to NEET status, evidence on the cumulative impact of early-life exposure to childhood adversity in the UK remains limited. MethodsWe analysed longitudinal data on 8,368 participants from the UK Millennium Cohort Study. Using group-based multi-trajectory modelli...

IntroductionLow educational attainment is associated with increased risk of COVID-19 mortality, but it remains unclear whether the link between education and COVID-19 mortality is causal or due to confounding factors, such as childhood socio-economic status or cognitive skills. To address this question, we evaluated whether older adults risk of COVID-19 mortality was associated with historical state-level compulsory schooling laws (CSLs) applicable when they were school-aged. We also evaluated w...

BackgroundHealth-related economic inactivity is a growing concern in the United Kingdom but little is known about how the relationship between health and work participation has changed across cohorts. MethodsWe used data from two British birth cohorts born in 1958 (National Child Development Study, n = 9,761) and 1970 (British Cohort Study, n = 7,336). We examined how self-reported chronic health conditions at age 42 (longstanding illness, obesity, diabetes, high blood pressure, back pain, and ...

BackgroundThere are concerns that mortality remains elevated after peaks COVID-19. This study examined whether mortality rates in England and Scotland in 2022 were excessive compared to rates predicted by austerity-era (2012-2019) and pre-austerity (2001-2010) trends. MethodsA linear time trend analysis was conducted using mortality data from 2001-2022. The outcomes were observed and expected age- and sex-standardised mortality rates (ASMRs; standardised to the 2013 European Standard Population...

BackgroundChildhood adversity is multi-layered, extending beyond the family to include broader neighborhood contexts, and individual risks such as being born preterm or childhood physical and mental health issues. MethodsWe undertook a population-based study using Danish nationwide register data on multi-layered childhood adversity (individual, family and neighborhood adversity), and premature mortality. Children who were alive and resident in Denmark until their 16th birthday were followed int...

Childhood adversities are common and linked to increased risk of premature mortality, including deaths from accidents in early adulthood. We examined associations between childhood adversity and specific types of lethal accidents using nationwide register data from 1,282,636 individuals in the DANish LIFE course (DANLIFE) cohort born between Jan 1, 1980, and Dec 31, 2001, who did not die or emigrate before age 16. Individuals were classified into five trajectory groups based on annual exposure t...

BackgroundTime off work after workplace injury varies by compensation system. While often attributed to features of the compensation system, unaccounted regional factors may drive much of the effect. In this study, we compare disability durations by state and territory of residence within a single national workers compensation system. Large differences would indicate that factors other than compensation system settings are responsible for system effects observed in previous studies. MethodsWe a...