BMJ 2002;325:131-134 ( 20 July )

Papers

Are inequalities in height underestimated by adult social position? Effects of changing social structure and height selection in a cohort study

Chris Power, professor, ^a Orly Manor, senior lecturer, ^b Leah Li, statistical research fellow. ^a

^a Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London WC1N 1EH, ^b School of Public Health and Community Medicine, Hebrew University, Hadassah, PO Box 12272, Jerusalem 91120, Israel

Correspondence to: C Power cpower{at}ich.ucl.ac.uk

Objectives: To investigate whether changing social structure and social mobility related to height generate (inflate) inequalities in height.
Design: Longitudinal 1958 British birth cohort study.
Setting: England, Scotland, and Wales.
Participants: 10 176 people born 3-9 March 1958 for whom data were available at age 33 years.
Main outcome measures: Adult height and social class at age 33 years; class of origin (father's occupation when participant was 7 years old).
Results: Adult height showed a social gradient with class at age 7 years and age 33 years. The difference in mean height between extreme groups was greater for class of origin than for adult class, reducing from 2.21 cm to 1.62 cm for men and from 2.18 cm to 1.74 cm for women. This narrowing inequality was due mainly to a decrease in mean height in classes I and II. This was because of the pattern of height related social mobility in which, for example, men moving into classes I and II were taller (mean 177.2 cm) than men remaining in class III manual (mean 176.1 cm) yet shorter than men with class I and II origins (mean 178.3 cm) and the relatively large number of individuals moving into classes I and II. Changes in the structure of society, seen here with the general trend of upward social mobility, have acted to diminish inequalities in adult height.
Conclusions: The combination of changing social structure and height related mobility constrains, rather than inflates, inequalities in height and may lead to an underestimation of the role of childhood socioeconomic factors in the development of inequalities in adult disease.

What is already known on this topic Changes in the structure of society (artefact) and health related social mobility (selection) are thought to generate inequalities in health, but the strength and direction of effects are not fully appreciated Adult height is a risk marker for cardiorespiratory disease and a useful index with which to assess effects of social mobility What this study adds Inequalities in height were not inflated as a result of social mobility and changes in social structure These social forces acted to obscure an effect of childhood socioeconomic circumstances Inequalities would have been greater in the absence of the general trend of upward social mobility between generations and the tendency for taller people to be upwardly mobile

---

© BMJ 2002
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    Twitter    What's this?

Relevant Articles

Sex differences in occupation may affect height associations

Geoff Der
BMJ 2002 325: 903. [Extract] [Full Text]

Social trends conceal inequalities in adult height
BMJ 2002 325: 0. [Full Text]

This article has been cited by other articles:

• Webb, E, Kuh, D, Peasey, A, Pajak, A, Malyutina, S, Kubinova, R, Topor-Madry, R, Denisova, D, Capkova, N, Marmot, M, Bobak, M (2008). Childhood socioeconomic circumstances and adult height and leg length in central and eastern Europe. J. Epidemiol. Community Health 62: 351-357 [Abstract] [Full text]  
• Barros, A., Victora, C., Horta, B., Goncalves, H., Lima, R., Lynch, J (2006). Effects of socioeconomic change from birth to early adulthood on height and overweight. Int J Epidemiol 35: 1233-1238 [Abstract] [Full text]  
• Fairley, L, Leyland, A H (2006). Social class inequalities in perinatal outcomes: Scotland 1980-2000. J. Epidemiol. Community Health 60: 31-36 [Abstract] [Full text]  
• Moody-Ayers, S. Y., Mehta, K. M., Lindquist, K., Sands, L., Covinsky, K. E. (2005). Black-White Disparities in Functional Decline in Older Persons: The Role of Cognitive Function. J Gerontol A Biol Sci Med Sci 60: 933-939 [Abstract] [Full text]  
• Sacker, A., Clarke, P., Wiggins, R. D, Bartley, M. (2005). Social dynamics of health inequalities: a growth curve analysis of aging and self assessed health in the British household panel survey 1991-2001. J. Epidemiol. Community Health 59: 495-501 [Abstract] [Full text]  
• Langenberg, C., Shipley, M. J., Batty, G. D., Marmot, M. G. (2005). Adult Socioeconomic Position and the Association Between Height and Coronary Heart Disease Mortality: Findings From 33 Years of Follow-Up in the Whitehall Study. AJPH 95: 628-632 [Abstract] [Full text]  
• Li, L, Manor, O, Power, C (2004). Are inequalities in height narrowing? Comparing effects of social class on height in two generations. Arch. Dis. Child. 89: 1018-1023 [Abstract] [Full text]  
• Morrison, D. S (2004). Small steps. J. Epidemiol. Community Health 58: 679-679 [Full text]  
• Elstad, J. I. (2004). Health and Status Attainment: Effects of Health on Occupational Achievement among Employed Norwegian Men. Acta Sociologica 47: 127-140 [Abstract]  
• Wright, C. M, Parker, L. (2004). Forty years on: the effect of deprivation on growth in two Newcastle birth cohorts. Int J Epidemiol 33: 147-152 [Abstract] [Full text]  
• Der, G. (2002). Sex differences in occupation may affect height associations. BMJ 325: 903-903 [Full text]  

Rapid Responses:

Read all Rapid Responses

Where is the statistical analysis?

Adam Jacobs
bmj.com, 22 Jul 2002 [Full text]

Where is the statistical analysis?

Adam Jacobs
bmj.com, 22 Jul 2002 [Full text]

Where is the statistical analysis?

Adam Jacobs
bmj.com, 22 Jul 2002 [Full text]

Social inequalities in height - gender differences in occupational structure suggest caution

Geoff Der
bmj.com, 25 Jul 2002 [Full text]

Online poll

Find out more>>