Childhood socioeconomic circumstances and adult mortality: a systematic review and meta-analysis

Childhood socioeconomic circumstances are important determinants of adult health, yet no recent meta-analysis has quantified these associations or formally assessed evidence certainty. We aimed to synthesise evidence on associations between childhood socioeconomic circumstances and adult all-cause and cause-specific mortality.

For this systematic review and meta-analysis, we searched MEDLINE, SocIndex, ASSIA, and ProQuest Public Health from inception to May 26, 2026, without language restrictions, supplemented by backward citation searching. We included cohort studies examining associations between childhood socioeconomic conditions (parental education and occupation, economic circumstances, housing and material conditions, and composite indicators) and adult mortality (age ≥18 years), reporting quantitative estimates with extractable data. No randomised controlled trials were identified; all included studies were observational longitudinal studies. Two reviewers independently screened records and extracted data. Risk of bias was assessed using ROBINS-E and evidence certainty using GRADE. We pooled hazard ratios (HRs) using random-effects meta-analysis with restricted maximum likelihood estimation and calculated the relative index of inequality (RII) to enable standardised comparisons across exposure definitions. This study is registered with PROSPERO (CRD42024594671).