Lifecourse influences on health among British adults: Effects of region of residence in childhood and adulthood

David P. Strachan, Alicja R. Rudnicka, Chris Power, Peter Shepherd, Elizabeth Fuller, Adrian Davis, Ian Gibb, Meena Kumari, Ann Rumley, Gary J. Macfarlane, Jugnoo Rahi, Bryan Rodgers, Stephen Stansfeld

    Research output: Contribution to journalArticlepeer-review


    Background: It has been suggested that early life exposures are important determinants of geographical variations in adult diseases. We examined inter-regional migrants in Britain to evaluate the relative importance of early and recent exposures for adult cardiorespiratory risk factors, mental ill-health and sensory function. Methods: A total of 9023 persons born throughout England, Scotland and Wales during 1 week in 1958 were followed periodically through childhood into adulthood. At 44-45 years, height, body mass index (BMI), blood pressure (BP), glycosylated haemoglobin, total and high-density lipoprotein (HDL) cholesterol, triglycerides, fibrinogen, total immunoglobulin E (IgE), one-second forced expiratory volume (FEV1), hearing threshold at 4kHz, visual impairment, symptoms of depression and anxiety, and chronic widespread pain were measured. Analysis of migration between 12 regions included 3125 cohort members who were examined in a region different to their birthplace. Results: Height, BMI, diastolic BP (DBP), FEV1, log-transformed IgE and hearing threshold varied by region among non-migrants (each P <0.05). Among inter-regional migrants, the spatial associations with current region, independent of birthplace, followed closely the geographical pattern shown among non-migrants for BMI, DBP and FEV1 (each P <0.001). In contrast, of the 15 outcomes, only adult height was related to region of birth, after adjustment for region of examination (P = 0.002) Conclusions: Although individual disease risk is predicted by early life factors, early exposures do not explain regional variations in cardiovascular and respiratory risk factors among middle-aged adults in Britain. Geographical inequalities in cardiorespiratory health are more strongly related to factors associated with region of examination that influence obesity, BP and ventilatory function. © Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.
    Original languageEnglish
    Pages (from-to)522-531
    Number of pages9
    JournalInternational Journal of Epidemiology
    Issue number3
    Publication statusPublished - Jun 2007


    • Adult
    • Blood Pressure
    • Body Height
    • Body Mass Index
    • epidemiology: Cardiovascular Diseases
    • epidemiology: England
    • Epidemiologic Methods
    • Forced Expiratory Volume
    • Health Status
    • Humans
    • blood: Immunoglobulin E
    • Infant, Newborn
    • epidemiology: Mental Disorders
    • Middle Aged
    • Residence Characteristics
    • epidemiology: Respiration Disorders
    • epidemiology: Scotland
    • Transients and Migrants
    • epidemiology: Wales


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