Family socioeconomic position at birth and future cardiovascular disease risk: Findings from the Aberdeen children of the 1950s cohort study

Objectives. We assessed the association of father's social class, recorded at the time of birth, with coronary heart disease and stroke in a British cohort of 11 106 individuals born in the 1950s. Methods. Survival analysis was used to relate social class at birth to the occurrence of either fatal or nonfatal coronary heart disease or stroke. Results. Rates of coronary heart disease and stroke increased across the social class distribution from highest to lowest, and patterns of association were similar for the 2 outcomes. The gender-adjusted hazard ratio of experiencing either coronary heart disease or stroke comparing the manual and nonmanual social class categories was 1.52 (95% confidence interval [CI] = 1.14, 2.02). This ratio fell to 1.41 (95% CI = 1.05, 1.88) after adjustment for indicators of intrauterine and childhood growth. Further adjustment for educational attainment reduced the ratio to 1.28 (95% CI = 0.94, 1.75). Conclusions. We found that social class at birth was associated with risk of fatal and nonfatal cardiovascular disease among individuals born in the 1950s, a period of relative prosperity and after the introduction of the welfare state in Britain. This relation appeared to be mediated in part through educational attainment.