Life-course socioeconomic position and health in older adulthood: a causal mediation analysis in the 1958 British Birth Cohort

Summary: Background: Childhood socioeconomic position (SEP) influences later health, but how inequalities persist into early older age and operate through adult SEP remains unclear. Quantifying these pathways is important for identifying opportunities to reduce health inequalities over the life course. We therefore used an interventional causal mediation framework to quantify the contribution of four distinct dimensions of adult SEP to childhood socioeconomic inequalities in self-reported and objective health outcomes in early older age.

Methods

We analysed data from the 1958 British Birth Cohort collected at birth, ages 33 and 55, and the most recent sweep, when participants were aged 60–66 years. Sample sizes ranged from 4014 to 8363 depending on the outcome. We examined the extent to which four dimensions of adult SEP — adult occupational class, education, housing tenure, and income — mediated associations between childhood SEP, measured by paternal occupational class at birth, and self-rated health (SRH), C-reactive protein (CRP), cholesterol ratio, glycated haemoglobin (HbA1c), and NT-proBNP.