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- Khatun, Masuma, 1969-, et al.
(författare)
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The influence of factors identified in adolescence and early adulthood on social class inequities of musculoskeletal disorders at age 30 : A prospective population-based cohort study
- 2004
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Ingår i: International Journal of Epidemiology. - : International Epidemiological Association. - 0300-5771 .- 1464-3685. ; 33:6, s. 1353-1360
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Tidskriftsartikel (refereegranskat)abstract
- Background Social class inequities have been observed for mostmeasures of health. A greater understanding of the relativeimportance of different explanations is required. In this prospectivepopulation-based cohort study we explored the contribution offactors, ascertained at different stages between adolescenceand early adulthood, to social class inequities in musculoskeletaldisorders (MSD) at age 30.Methods We used data from 547 men and 497 women from a townin north Sweden who were baseline examined at age 16 and followedup to age 30. Using logistic regression models, we estimatedthe unadjusted odds ratios (OR) for MSD for blue-collar versuswhite-collar workers in men and women separately. We assessedthe contribution of different factors identified between adolescenceand early adulthood by comparing the unadjusted OR for socialclass differences with OR adjusted for these explanatory factors.Results We found significant class differences at age 30 withhigher MSD among blue-collar workers (OR = 2.03 in men [95%CI: 1.42, 2.90] and 1.98 in women [95% CI: 1.29, 3.02]). Afteradjustment for explanatory factors, class differences decreasedand were no longer significant, with OR of 1.20 in men (95%CI: 0.76, 1.95) and 1.18 in women (95% CI: 0.69, 2.03). Schoolgrades at age 16; being single and alcohol consumption at age21; having children, restricted financial resources, physicalactivity, alcohol consumption, smoking, and working conditionsat age 30 were important for men; parents' social class, schoolgrade, smoking and physical activity at age 16; being singleat age 21; and working conditions at age 30 were important forwomen.Conclusion The accumulation of adverse behavioural and socialcircumstances from adolescence to early adulthood may be anexplanation for the class differences in MSD at age 30. Interventionsaimed at reducing health inequities need to consider exploratoryfactors identified at early and later stages in life, also includingstructural determinants of health.
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