Childhood socioeconomic position and later-life mortality, morbidity and self-rated health: a linked study from the Historical Population Register of Norway and the Tromsø Study 1950-2022.
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AIMS: Previous studies on childhood socioeconomic position (CSEP) and health have mostly focused on outcomes in early to mid-life or relied on recalled CSEP in adulthood. The objective of this study was to investigate the association of prospectively measured CSEP with a variety of health outcomes in mid to old age among residents in Northern Norway. METHODS: This study linked health data from the population-based Tromsø Study to the Historical Population Register of Norway. Using Cox proportional hazards models, logistic and ordinal logistic regression, we investigated sex-specific associations between fathers' occupation in 1950 and all-cause mortality (n=7056), as well as chronic disease prevalence and self-rated health (n=4576) at age 50 years and older among Tromsø Study participants born in 1930-1955. RESULTS: Self-rated health showed the strongest association with CSEP and a clear social gradient that was more pronounced among women. We found only minor differences in all-cause mortality and varying patterns for prevalence of chronic diseases by CSEP. High CSEP was associated with lower prevalence of chronic respiratory diseases for both women and men, and higher odds for cancer among women. Associations were attenuated when educational level was included in the models. CONCLUSIONS: Prospectively measured CSEP was associated with later-life health, although to a varying degree depending on the health indicator under study. This study highlights that, beyond binary disease endpoints, a broad indicator such as self-rated health can be an important tool to uncover health inequalities by CSEP in later life, as it summarises a multitude of possible dimensions of health and wellbeing throughout the life course.