note reference to irreversability of CVD risk from childhood.

   The Lancet,    Vol: 360, Issue: 9346, November 23, 2002,  pp. 1640-1645

 Association between children's experience of socioeconomic
                disadvantage and adult health: a life-course study

 Poulton, Richiea; Caspi, Avshalomb; Milne, Barry J; Thomson, W
Murrayc;  Taylor, Alanb; Sears, Malcolm Rd; Moffitt, Terrie Eb

Affiliations:  a. Dunedin Multidisciplinary Health and Development Research
Unit, Department of Preventive and Social Medicine, Dunedin School of
Medicine, University of Otago, PO Box 913, Dunedin, New Zealand
b. Institute of Psychiatry, King's College, London, UK c. Department of Oral
Health, University of Otago Dental School,
 Dunedin, New Zealand, d. Department of Medicine, McMaster University, Hamilton,
Ontario, Canada

 Abstract
                Background Research into social inequalities in health has
tended to focus on  low socioeconomic status in adulthood. We aimed to test the
hypothesis that children's experience of socioeconomic disadvantage is
associated with a wide range of health risk factors and outcomes in adult life.

               Methods We studied an unselected cohort of 1000 children (born
in New Zealand during 1972-73) who had been assessed at birth and ages
3, 5, 7, 9, 11, 13, and 15 years. At age 26 years, we assessed these
individuals for health outcomes including body-mass index, waist:hip ratio,
blood
pressure, cardiorespiratory fitness, dental caries, plaque scores,
gingival bleeding, periodontal disease, major depression, and tobacco and
alcohol
dependence, and tested for associations between these variables and
childhood and adult socioeconomic status.

                Findings Compared with those from high socioeconomic status
backgrounds,  children who grew up in low socioeconomic status families had
poorer    cardiovascular health. Significant differences were also found
on all dental health  measures, with a threefold increase in adult periodontal
disease
 and caries level (32=B72% vs 9=B79%) in low versus high childhood
socioeconomic status groups. Substance abuse resulting in clinical
 dependence was related in a similar way to childhood
socioeconomic status (eg, 21=B75% vs 12=B71% for adult alcohol dependence). =
The longitudinal associations could not be attributed to life-course continuity
of low socioeconomic status, and upward mobility did not mitigiate or
reverse the adverse effects of low childhood socioeconomic status on adult
health.

                Interpretation Protecting children against the effects of
socioeconomic adversity could reduce the burden of disease experienced
d byadults. These findings provide strong impetus for policy makers,
practitioners, and researchers to direct energy and resources towards childhood
as a way
of improving population health.

 Citations: 30 in original article...

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