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Socioeconomic position in childhood and adulthood and insulin resistance: cross sectional survey using data from British women's heart and health study

BMJ 2002; 325 doi: (Published 12 October 2002) Cite this as: BMJ 2002;325:805
  1. Debbie A Lawlor (d.a.lawlor{at}, MRC research training fellow,
  2. Shah Ebrahim, professor,
  3. George Davey Smith, professor.
  1. Department of Social Medicine, University of Bristol, Bristol BS8 2PR
  1. Correspondence to: D A Lawlor
  • Accepted 15 May 2002


Objective: To assess the associations between childhood and adulthood social class and insulin resistance.

Design: Cross sectional survey.

Setting: 23 towns across England, Scotland, and Wales.

Participants: 4286 women aged 60-79years.

Main outcome measures: Insulin resistance and other cardiovascular disease risk factors.

Results: Belonging to manual social classes in childhood and in adulthood was independently associated with increased insulin resistance, dyslipidaemia, and general obesity. The association between childhood social class and insulin resistance was stronger than that for adult social class. The effect, on insulin resistance and other risk factors, of belonging to a manual social class at either stage in the life course was cumulative, with no evidence of an interaction between childhood and adult social class. Women who were in manual social classes in childhood remained at increased risk of insulin resistance, dyslipidaemia, and obesity—even if they moved into non-manual social classes in adulthood—compared with women who were in non-manual social classes at both stages.

Conclusions: Adverse social circumstances in childhood, as well as adulthood, are strongly and independently associated with increased risk of insulin resistance and other metabolic risk factors.


  • Funding The British women's heart and health study is funded by the Department of Health. DAL is funded by a Medical Research Council/Department of Health training fellowship. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health or Medical Research Council.

  • Conflict of interest None declared.

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