Health in mid-life: the impact of development trajectories.

1. Health in mid-life: the impact of development trajectories. Chris Power Centre for Paediatric Epidemiology & Biostatistics Institute of Child Health

2. Childhood and adult health: lifecourse framework cognitive & educational trajectories adult circumstances social trajectories infant health behaviour adult health physical and mental health birth starting pre/school leaving school Graham & Power 2004 Graham, Power. Childhood disadvantage and health inequalities. Child: Care, Health & Devel 2004; 30,671-8

3. Social destinations for children born in 1958 by social class origins. * ≥ person per room. + bathroom, indoor toilet, hot water supply Power and Matthews, 1997

4. Proportion of women# alive after 45 years of follow-up by childhood social position I & II professional & managerial III non-manual III manual unskilled manual IV & V # mothers of the 1958 cohort Power et al, 2005

5. Poor health at age 33 and lifetime SEP (birth - 33yrs) best worst Power et al, 1999

6. Vocabulary Growth – First 3 Years Vocabulary 1200 High SES Middle SES 600 Low SES 0 12 16 20 24 28 32 36 Age - Months B. Hart & T. Risley, Meaningful Differences in Everyday Experiences of Young American Children, 1995

7. Cognitive development* (7-16y) & social origins * Maths tests (excl low birthwt) Jefferis et al, 2002

8. Childhood and adult health: lifecourse framework cognitive & educational trajectories adult circumstances social trajectories infant health behaviour adult health physical and mental health birth starting pre/school leaving school Graham & Power 2004 Graham, Power. Childhood disadvantage and health inequalities. Child: Care, Health & Devel 2004; 30,671-8

9. Binge drinking and qualifications Women Men Jefferis et al, 2006

10. Social class of origin & adult current smoking (smoker v ex and never smokers): men Jefferis et al, 2004

11. Odds Ratio (95% CI) for quitting smoking associated with manual childhood SEP women men Power et al, 2005 age-adjusted ORs and adjusted for adult SEP

12. Childhood and adult health: lifecourse framework cognitive & educational trajectories adult circumstances social trajectories infant health behaviour adult health physical and mental health birth starting pre/school leaving school Graham & Power 2004 Graham, Power. Childhood disadvantage and health inequalities. Child: Care, Health & Devel 2004; 30,671-8

13. Odds Ratios (95% CI) for disability* by birthweight in females 6 5 7 years 33 years 4 OR 3 2 1 0 <2,500 2500 – 3249 3250 – 3749 3750 – 4249 >4249 birthweight *new cases Power & Li, 2000

14. BMI (mean) & social class at birth

15. Systolic blood pressure by birth weight & father’s social class (regression coefficients from separate models fitted at each age, adjusted for sex) Birth weight Manual social class Hardy et al. 2003

16. Summary: By following individuals through their lives, we are building evidence on : • the childhood origins of some adult health outcomes (partly through developmental trajectories) • the timing and sequence of risks /processes that lead to social inequalities in adult health. Policy implications can be specific to outcome, but generally: child development needs to be optimum because of its • immediate impact on health • potential to affect later health.