Adult body height and childhood socioeconomic group in the Swedish population

Associations Between Attention-Deficit/Hyperactivity Disorder (ADHD), ADHD Medication, and Shorter Height: A Quasi-Experimental and Family-Based Study

OBJECTIVE

The association between attention-deficit/hyperactivity disorder (ADHD) and shorter height is unclear. This study examined the risk of shorter height in individuals with ADHD, and the influence of prenatal factors, ADHD medication, psychiatric comorbidity, socioeconomic factors, and familial liability.

METHOD

We drew on Swedish National Registers for 2 different study designs. First, height data for 14,268 individuals with ADHD and 71,339 controls were stratified into 2 groups: (1) before stimulant treatment was introduced in Sweden, and (2) after stimulant treatment was introduced in Sweden. Second, we used a family-based design including 833,172 relatives without ADHD with different levels of relatedness to the individuals with ADHD and matched controls.

RESULTS

ADHD was associated with shorter height both before (below-average height: OR = 1.31, 95% CI = 1.22-1.41) and after (below-average height: OR = 1.21, 95% CI = 1.13-1.31) stimulants for ADHD were introduced in Sweden, and was of similar magnitude in both cohorts. The association between ADHD and shorter height attenuated after adjustment for prenatal factors, psychiatric disorders, and socioeconomic status. Relatives of individuals with ADHD had an increased risk of shorter height (below-average height in full siblings: OR = 1.14, 95% CI = 1.09-1.19; maternal half siblings: OR = 1.10, 95% CI = 1.01-1.20; paternal half siblings: OR = 1.15, 95% CI = 1.07-1.24, first full cousins: OR = 1.10, 95% CI = 1.08-1.12).

CONCLUSION

Our findings suggest that ADHD is associated with shorter height. On a population level, this association was present both before and after ADHD medications were available in Sweden. The association between ADHD and height was partly explained by prenatal factors, psychiatric comorbidity, low socioeconomic status, and a shared familial liability for ADHD.

Short men in poor lands: The agrarian workers from southwestern Spain in anthropometric perspective

With a sample of heights of almost 60,000 men, born between 1855 and 1979 and recruited between 1876 and 2000, our work analyzes the nutritional gap between the agrarian and non-agrarian population in Extremadura, a Spanish region located among the poorest ones in Europe. The analysis reveals that this difference is not only statistically significant, but also tends to increase as the average stature of the active population grows. Among the causes of the agrarian height penalty, our article focuses mainly on the economic differences. However, the research also insists on the roots of these differences, especially those linked to the adverse physical conditions of the territory, the dynamics of the Christian conquest in the Middle Ages and the strong and persistent concentration of land ownership in the region. In short, this paper concludes that the anthropometric gap between agrarian and non-agrarian workers is due not only to economic causes, but also to geographical, historical and institutional reasons.

The effect of different socio-economic and working conditions on body size and proportions: A case study on adults from Samsun, Turkey

Conditions in the early stages of life shape body size and proportions. This study includes individuals who came from different socio-economic conditions and worked in physically demanding jobs in childhood. By determining the body sizes of these individuals and evaluating the proportional relationships between several groups, the goal was to understand the effect levels of socio-economic levels and working conditions on the body. For this purpose, an anthropometric study was conducted on 623 males and females between the ages of 20 and 45 living in Samsun, Turkey. The study sample consisted of four different groups. It was divided into two main groups of high and low socio-economic level, and the low socio-economic group was divided into two subgroups of heavy-worker and nonheavy-worker. The results demonstrated that socio-economic differences in the size and proportions of the individuals were statistically significant (p<0.05). The high socio-economic group had the highest values in all measures. External factors affected the lower limbs more than the upper limbs. The measurement most affected by these factors was leg length. Longer legs characterized the high socio-economic group, while longer arms characterized both low socio-economic groups. The relative differences observed can be said to derive from the distal limbs. This finding was valid for both sexes. The average values were close to each other in the low socio-economic group, for which the aim was to comprehend the effects of heavy working conditions. However, differences in proportional relationships were more significant. In this context, it was seen that heavy labour also affected growth, in addition to the well-known factors encountered during the growth period, such as nutrition, health, and illness. The observed changes were more significant in males than in females. Thus, it can be said that males were more affected by physiological and physical conditions.

A Complex Systems Model of Breast Cancer Etiology: The Paradigm II Conceptual Model

BACKGROUND

The etiology of breast cancer is a complex system of interacting factors from multiple domains. New knowledge about breast cancer etiology continues to be produced by the research community, and the communication of this knowledge to other researchers, practitioners, decision makers, and the public is a challenge.

METHODS

We updated the previously published Paradigm model (PMID: 25017248) to create a framework that describes breast cancer etiology in four overlapping domains of biologic, behavioral, environmental, and social determinants. This new Paradigm II conceptual model was part of a larger modeling effort that included input from multiple experts in fields from genetics to sociology, taking a team and transdisciplinary approach to the common problem of describing breast cancer etiology for the population of California women in 2010. Recent literature was reviewed with an emphasis on systematic reviews when available and larger epidemiologic studies when they were not. Environmental chemicals with strong animal data on etiology were also included.

RESULTS

The resulting model illustrates factors with their strength of association and the quality of the available data. The published evidence supporting each relationship is made available herein, and also in an online dynamic model that allows for manipulation of individual factors leading to breast cancer (https://cbcrp.org/causes/).

CONCLUSIONS

The Paradigm II model illustrates known etiologic factors in breast cancer, as well as gaps in knowledge and areas where better quality data are needed.

IMPACT

The Paradigm II model can be a stimulus for further research and for better understanding of breast cancer etiology.

The relationship between adult stature and longevity: tall men are unlikely to outlive their short peers – evidence from a study of all adult deaths in Poland in the years 2004–2008

Early epidemiological studies demonstrated that short stature is associated with cardiovascular disease (CVD), diabetes, lower energy intake or food deprivation during growth, poor health, and increased all-cause mortality. Nevertheless, the links between adult height and longevity become tenuous if certain confounders (e.g. BMI, SES, educational attainment, etc.) are allowed for. Furthermore, numerous studies have found that like excess weight, tallness is costly in terms of longevity in late ontogeny, and shorter people tend to outlive their taller peers, especially if they are slim and maintain a healthy diet and lifestyle. Therefore, there is currently a lack of agreement in the literature as to whether and how body height and lifespan are linked. The objective of this study was to explore the relationship between adult stature and longevity on the basis of a large sample from a population-based cohort study. Data on declared height and exact dates of birth and death were available from 480,493 men and 364,666 women who died in the years 2004-2008 in Poland. To control for secular changes, the sample was divided into fifteen birth cohorts and each group was subsequently split into five height categories using pentiles, separately for both sexes. The analysis has revealed an inverse relationship between height and lifespan in men and women. However, after controlling for secular changes in height, the relationship turned out to be very weak and linear in men, and inverted U-shaped in women. In general, taller individuals had lower age at death compared to shorter ones, and this relationship was more pronounced and consistent in men. To sum up, these findings do not comport with the traditional belief that taller individuals live longer. The role of several possible biological mechanisms pertinent to enhanced longevity in smaller individuals was emphasized, and these biological factors were discussed.

Socio-economic Position, Gender and Health

There is a large research literature on socio-economic inequalities in health (and explanations for these inequalities); there is also a large literature on gender differences in health (and explanations for these differences). However, the two bodies of research are rarely integrated to ask, for example, whether socio-economic inequalities vary by gender, or whether gender differences vary by socio-economic position. The separation of these two research traditions may be to the detriment of theoretical development in both of them; and in particular, asymmetrical treatment of men and women in research in inequalities in health may hinder our ability to explain the mechanisms producing inequalities. This article reviews the intersection of socio-economic position and gender, and argues for more systematic and symmetrical examination of the interaction between socio-economic position and gender in the social patterning of health.

Long-term changes of socioeconomic differences in height among young adult men in Southern Sweden, 1818-1968

The study explores the long-term trends in socioeconomic differences in height among young adult men. We linked information from conscript inspections to a longitudinal demographic database of five parishes in Southern Sweden. Detailed information on the occupation and landholding was used to investigate the differences in height. Even if there is indication of a reduction in the magnitude of the differences in height over time the reduction is neither dramatic nor uniform. The most systematic and consistent difference is that sons of fathers with white collar occupations were taller than others. They were 4cm taller than the sons of low-skilled manual workers in the first half of the 19th century, and almost 2cm taller in the mid-20th century. This difference is much smaller than those found between elite and destitute groups historically, in for example Britain, but comparable to that found in other studies on 19th century populations using information on family background. Most of the reduction in the socioeconomic differences in height was a result of reduced height penalty and premium for small disadvantaged and privileged groups. Changes in the distribution of income and the economic structure are plausible explanations for the changes in socioeconomic differences in height.

Why pigs are important in Papua? Wealth, height and reproductive success among the Yali tribe of West Papua

Many studies have investigated how different variables influence the reproductive success (RS) in the populations of natural birth control. Here, we tested hypotheses about positive relationship between wealth, height and several measures of RS in an indigenous, traditional society from West Papua. The study was conducted among the Yali tribe in a few small, isolated mountain villages. In this tribe, a man's wealth is measured by the number of pigs he possesses. We found that wealth was related to fertility and number of living children, but not to child mortality in both men and women. Additionally, child mortality increased with the number of children in a family. Finally, we did not observe any relationship between height and reproductive success measures or wealth. We provide several possible explanations of our results and also put forward hypothetical background for further studies of indigenous populations.

The association of adolescent socioeconomic position and adult height: variation across racial/ethnic groups

Numerous studies have demonstrated the association of childhood socioeconomic position and adult height. Many have suggested the use of adult height as a marker of overall childhood well-being. However, few studies have examined the relationship between child/adolescent socioeconomic position and adult height in a racially/ethnically diverse cohort. Using the National Longitudinal Study of Adolescent Health, we examined the association of child/adolescent SEP (maternal education and maternal report of household income) and measured adult height in a diverse cohort of US adolescents/young adults. We found a positive gradient effect of maternal education on height in the overall population and in White and Mixed race males and females; no such gradient existed in Hispanic, Asian, or Black males or females. Only in Mixed race females was household income positively associated with height. These findings emphasize the need to recognize differential effects of socioeconomic status on height in different racial/ethnic and gender subpopulations.

VARIATION IN HEIGHT AND KNEE HEIGHT IN ADOLESCENTS IN MERIDA, MEXICO, BY HEAD OF HOUSEHOLD EMPLOYMENT LEVEL AND FAMILY INCOME

Variation in height among young adults has been linked to the living conditions of different social groups. The aim of this study was to measure variation in the height and knee height of young adults by head of household employment level and family income. The sample comprised 180 individuals (90 girls) aged 16 and 17 years living in the city of Merida, Mexico. Height and knee height were measured by anthropometry, and individuals' family social and economic data collected from their mothers. Variation in these measurements was analysed by three categories of employment and family income terciles. One-way ANOVAs were done by sex to compare mean height and knee height by employment and family income. Coefficients of variation were calculated and a Bartlett test applied. Significant differences in height and knee height were observed only between family income terciles. Both sexes were taller at the highest levels of family income (p<0.05) and men had the highest (p<0.05) knee height. Highest family income individuals exhibited the least variation in height and knee height. Similarity in socioeconomic conditions for families in the lowest family income tercile and with employee heads of household was not associated with lower variation of height and knee height.

Childhood circumstances and height among older adults in the United States

We investigated the association between adult height and three indicators of childhood circumstances: mother's education, childhood financial hardship, and childhood health in the United States. Cross-sectional analysis of adults aged 50 and older in the 2004 Health and Retirement Study (N = 14,079) was conducted. Gender and gender-race stratified regression models were used to model the association between adult height and childhood circumstances. The gender-stratified results showed a positive gradient association between mother's education and adult height; those reporting up to grade 8, high school graduate, and greater than high school education for their mother were 4.17 cm (p < 0.001), 4.92 cm (p < 0.001), and 5.83 cm (p < 0.001) taller for men and 2.57 cm (p < 0.001), 3.16 cm (p < 0.001), and 3.85 cm (p < 0.001) taller for women, respectively than those reporting no education for their mother. Childhood health was not statistically significantly associated with adult height, controlling for birth cohort, mother's education, and childhood financial hardship. Those who did not experience childhood financial hardship were slightly taller than those who did experience such hardship. Gender-race stratified results also showed a positive gradient association between mother's education and adult height; however, this association was only significant for white men and white women. The study reiterates the importance of childhood circumstances for adult height and for building health stock.

Trends in the association between height and socioeconomic indicators in France, 1970-2003

Average physical stature has increased dramatically during the 20th century in many populations across the world with few exceptions. It remains unclear if social inequalities in height persist despite improvements in living standards in the welfare economies of Western Europe. We examined trends in the association between height and socioeconomic indicators in adults over three decades in France. The data were drawn from the French Decennial Health Surveys: a multistage, stratified, random survey of households, representative of the population, conducted in 1970, 1980, 1991, and 2003. We categorised age into 10-year bands, 25-34, 35-44, 45-54 and 55-64 years. Education and income were the two socioeconomic measures used. The slope index of inequality (SII) was used as a summary index of absolute social inequalities in height. The results show that average height increased over this period; men and women aged 25-34 years were 171.9 and 161.2 cm tall in 1970 and 177.0 and 164.0 cm in 2003, respectively. However, education-related inequalities in height remained unchanged over this period and in men were 4.48 cm (1970), 4.71 cm (1980), 5.58 cm (1991) and 4.69 cm (2003), the corresponding figures in women were 2.41, 2.37, 3.14 and 2.96 cm. Income-related inequalities in height were smaller and much attenuated after adjustment for education. These results suggest that in France, social inequalities in adult height in absolute terms have remained unchanged across the three decades under examination.

Effect of Birth Weight and Socioeconomic Status on Children's Growth in Mashhad, Iran

Background. Socioeconomic status and birth weight are prominent factors for future growing of children. Also Studies show that this criterion is associated with reduced cognitive outcomes, school achievement, and adult work capacity. So in this paper we determined the effects of some socio-economic statuses and birth weight on physical growth of children in Mashhad, Iran. Method and materials. This is a cross sectional study that determined effect of socio-economic status and birth weight on weight, heighting and BMI of school age children. Healthy six years old children who were screened before enter, to school were eligible for participating in our study between 6 June 2006 and 31 July. Weight and standing height were documented at birth and measured at 6 years old. Then, their BMI were calculated in childhood period. Data were analyzed by using SPSS software. Result. Results show that some socio-economic variables and birth weight is associated with and, perhaps, influence the variation of growth in the children. The variables which show the most consistent and significant association were birth weight, sex, economic status and education of parents. Conclusion. In this paper, we found that birth weight, economic status and education parents of neonates have directly significant effect on growth childhood period. We recommended that paying attention to these criteria for improving growth of children in our society should be considered by authorities.

"Anything you can do, I can do bigger?": the ethics and equity of growth hormone for small normal children

This paper argues against the use of growth hormone (GH) for small normal children ("idiopathic" short stature) with the following considerations: ethical (philosophical) grounds, cost-economic implications, and the rationale for treating normal physiological variation with a potent pharmacological agent. The author would prefer to see health and economic resources being directed to correct nutritional and environmental deprivation among underprivileged groups in preference to providing GH injections for small normal children.

Height at age 18 years is a strong predictor of attained education later in life: cohort study of over 950,000 Swedish men

BACKGROUND

Adult body height has been related to socioeconomic position in cross-sectional studies. Intelligence, shared family factors, and non-familial circumstances may contribute to associations between height and attained education, but their relative importance has been difficult to resolve.

METHODS

A nation-wide record-linkage cohort study of over 950 000 Swedish men born 1950-75 followed with respect to attained education for up to 27 years after measurement of height at age 18 (baseline). The association between height and attained education in later life was investigated by logistic regression modelling with adjustment for age, geography, parental socioeconomic position, and cognitive ability. Shared family factors were accounted for in analyses of full-brother-pairs using conditional logistic regression.

RESULTS

The odds ratio (OR) for attaining higher education 7-27 years after baseline was 1.10 [95% confidence interval (95% CI) 1.09-1.10] in fully adjusted models per 5 cm increase in height. Men taller than 194 cm were two to three times more likely to obtain a higher education as compared with men shorter than 165 cm. The association remained within brother-pairs, OR 1.08 (95% CI 1.07-1.10), suggesting that non-familial factors contribute to the association between height and education attainment. A significant interaction (P < 0.0001) was found between year of birth, height, and attained education, showing slightly weaker associations among later birth cohorts.

CONCLUSIONS

The strong positive association between height and educational achievement remaining after adjustment for year of birth, parental socioeconomic position, other shared family factors, and cognitive ability may reflect educational discrimination based on height although residual confounding cannot be ruled out.

Are inequalities in height narrowing? Comparing effects of social class on height in two generations

OBJECTIVE

To determine whether social inequalities in height change across generations.

METHODS

The target population was from the 1958 British birth cohort, all born 3rd-9th March 1958, followed to 1991, and the offspring of one third of this population. Main outcomes were height measured at 7, 11, 16, and 33 years (cohort members) and once at 4-18 years (offspring). Multilevel models applied to associations of social class of origin with (a) child-to-adult growth trajectory (cohort members), (b) height (offspring), and (c) generational height increment.

RESULTS

Height inequalities were observed among cohort members, with differences >2.0 cm at all ages between classes I and II, and IV and V. By adulthood, the difference in mean height had declined significantly in boys and slightly in girls. A secular trend was seen between the two generations. While male offspring had a similar mean height to their fathers in classes I and II, boys in classes IV and V gained 2.1 cm (p<0.001). Height gains of female offspring were evident in all classes, with a greater gain in classes IV and V (non-significant). The social class effect on height was weaker among offspring, with a difference between classes I and II, and IV and V of less than 1 cm.

CONCLUSIONS

Social inequalities in height observed among the cohort weakened substantially in the next generation due to a greater height gain among offspring from manual classes. Inequalities in childhood height have narrowed between the two generations in this study.

Effects of different socioeconomic conditions on menarche in Turkish female students

PURPOSE

The aim of this study was to determine the age at menarche, the menarcheal features, and the association between menarcheal age and socioeconomic status in an urban area in Turkey. In addition, we tried to assess whether there is a relationship between age at menarche and body composition.

METHODS

We asked some questions about menarche of 1017 female adolescent students in the high schools of Manisa region. Height and weight were measured. The body mass index (BMI; kg/m2) was used as an index of relative weight. Adolescent girls were grouped into three socioeconomic status according to the educational and occupational levels of their parents. The age at menarche and the menarcheal pattern were evaluated according to the socioeconomic status.

RESULTS

The ages of girls involved in the study ranged between 14 and 18 years, with a mean of 15.7+/-1.1 years. Although the menarcheal age was found to be lower in girls with higher socioeconomic status, there was no significant difference between the three different socioeconomic status. In all of the three groups, menarche was more common in summer and fall than in spring and winter. Although the mother was an important source of knowledge in all groups, it was significantly more important in the group with high socioeconomic status. Adolescent girls with low socioeconomic status had fewer premenstrual complaints. However, there was no significant difference between the groups. We found an inverse correlation between menarcheal age and postmenarcheal weight and the BMI (r=-0.14, p=0.000). However, there was no correlation between menarcheal age and postmenarcheal height.

CONCLUSION

These results indicate that as the social status differences decrease, the difference observed in menarcheal age and pattern disappears in urban areas of developing countries. Menarcheal age may be an indicator of socioeconomic development. It does not influence postmenarcheal height; however, as menarcheal age decreases, BMI increases.

Is the association between short stature and myocardial infarction explained by childhood exposures--a population-based case referent study (SHEEP)

AIMS

This study was undertaken to examine the association between short stature and acute non-fatal myocardial infarction and to analyse causal mechanisms related to height with a focus on childhood risk factors.

METHOD

The SHEEP (Stockholm Heart Epidemiology Program) is a population-based case-referent study. The outcome was incident first events of myocardial infarction. The study base included all Swedish citizens aged 45 to 70, who lived in Stockholm County during 1992-94. This analysis is based on 967 male cases, 412 female cases and 1696 referents. Exposure information was obtained through questionnaires, interviews, health examinations, and obstetric records.

RESULTS

Adult height was inversely related to myocardial infarction. The odds ratio for men in the shortest quartile (< 173 cm) compared with the tallest was 1.78 (95% CI: 1.39, 2.28). For women the corresponding odds ratio in the shortest quartile (<159 cm) was 1.86 (95% CI: 1.28, 2.71). Height was also inversely associated with fetal growth and indicators of material resources during childhood. Within each social class of origin short stature was associated with number of siblings, lack of higher education, and absence of upward social mobility. Adjustment for childhood risk factors decreased the excess relative risk of short stature with around 25%. Adult social, behavioural, and biological risk factors could not explain the association. The findings were similar for men and women.

CONCLUSION

Height is associated with many risk factors of myocardial infarction, which increase the risk of disease through many different causal pathways. Childhood exposures have no dominant role in explaining the association between short stature and myocardial infarction.

Social background and age at menarche in Portuguese university students: a note on the secular changes in Portugal

Menarcheal age of a sample of Portuguese university students (n = 3366), born between 1972 and 1983, age 18-23 years, was analyzed. The influence of parents' educational level and occupation, family size, birth order, and degree of urbanization of girl's locality of residence during childhood and adolescence were analyzed as well as secular trend in the Portuguese population. Mean age at menarche for girls born in 1983 was 12.32 years. Parents' educational level and occupation did not show any significant influence on mean age at menarche. Place of residence during childhood years and adolescence showed a significant effect on mean age at menarche, with girls from rural places with a later age at menarche than those who spent their childhood or adolescence in urban areas (P <or= 0.01 and P <or= 0.05 for childhood and adolescence, respectively). Family size and birth order showed the highest effect. Girls born in small families, with one child, matured earlier (12.32 years) than those born in large families with four or more children (12.67 years), (P <or= 0.01). Also, girls that were first-born had an earlier menarche (12.41 years) than those who were third or later (12.58 years, P <or= 0.01). Regression analysis selected family size and place of residence in childhood as the most important determinants of mean age at menarche in our university students. In this sample, from 1972 to 1983, mean age at menarche remained stable. When we considered published data from all the Portuguese population we found a decrease in mean age at menarche from 15 years for girls born in 1880 to 12.44 for those born in the 1980s. This decrease was the result of great improvements in the social and economic living conditions that occurred in Portugal especially after the 1970s concerning nutrition and health care, among many other environmental factors.

Stature and stature distribution in Portuguese male adults 1904-1998: the role of environmental factors

The records of height of 841,457 18-year-old Portuguese males were analyzed by area of residence (districts). The sample included all Portuguese 18-year-old males born between 1966 and 1979 and examined between 1985 and 1998, in the north, center, and south of Portugal. They represent all social strata. There were statistically significant differences (P < or = 0.001) among districts: males from Lisbon (172.8 cm) and Setúbal (172.7 cm), the most developed districts, were tallest, and those from Madeira (169.7 cm) and Coimbra (171.6 cm) were shortest. Compared with published data for 1904, there was a positive secular trend in height. The average increase was 8.93 cm and the estimated rate was 0.99 cm per decade. The changes that occurred were mainly the result of the reduction of the shortest classes of stature, those < 150 cm to 170 cm, and an increase in the frequency of the highest classes, > or = 170 cm. This positive trend and the changes in stature distribution must be related to the general improvement in standard living conditions that occurred in Portugal primarily after the 1960s and 1970s, especially in terms of nutrition and the health system. Taking into account the socioeconomic differences that still exist between districts, the results suggest that the secular trend in height should continue for the Portuguese population in future decades.

Height and body weight in elderly adults: a 21-year population study on secular trends and related factors in 70-year-olds

BACKGROUND

Body size in elderly adults is partly due to aging and partly to secular trends. This study describes secular trends in three anthropometric measures (i.e., height, body weight [BW], and body mass index [BMI]) of 70-year-olds over a period of 21 years and their relation to social and lifestyle factors.

METHODS

A total of 3128 70-year-olds from four birth cohorts born between 1901 and 1922 in Gothenburg, Sweden, were examined between 1971 and 1992 in the Geriatric Medicine Department, Göteborg University. Trends in anthropometric measures were examined by permutation test. Influence of the subjects' birth year, physical activity, smoking habits, and education on anthropometric measures were investigated by multiple linear regression.

RESULTS

Individuals in later-born cohorts were found to be 1 to 2 cm taller and 1.5 to 6.3 kg heavier than earlier-born cohorts. For BMI, a positive trend was significant only in 70-year-old male participants. "Year of birth" was a positive predictor for BW (p <.001) and BMI (p <.001) in male participants and for height (p <.05) and BW (p <.01) in female participants. Physical inactivity was a positive (p <.01) and "current smoking" a negative (p <.001) predictor for BMI in both sexes. "More than basic education" was a positive predictor for height (p <.001) in both sexes and a negative predictor for body weight (p <.01) and BMI (p <.001) in female participants only.

CONCLUSIONS

Trends of increasing height, BW, and BMI were found among the Swedish elderly participants. This may be partly due to differences in smoking habits, physical activity, education, food habits, childhood nutrition, and living conditions between the cohorts.

Short stature and poor psychological performance: risk factors for attempted suicide among Swedish male conscripts

OBJECTIVE

To investigate potential risk factors of attempted suicide among young male conscripts without previous attempts.

METHODS

A nation-wide cohort of young men in Sweden was followed to observe the occurrence of attempted suicide after military-enlistment examination. Information from the examination was linked with data from national hospital in-patient and other registries.

RESULTS

150,395 Swedish young men born during 1973-75 were followed for up to 2 years. One hundred and fifty-five people made suicide attempts during the follow-up period. Body height, suitability for being an officer and performance in a logic test at the examination were included in a final multivariate Cox regression model, and found to be significantly inversely associated with the risk of attempted suicide.

CONCLUSION

The results suggest for the first time that short stature and poor psychological performance at conscription examination may be helpful to identify groups with increased risk of attempted suicide during 1-1.5 years after enlistment.

Low physical capacity among adolescents in practical education

The aim of this study was to obtain better knowledge about teenagers' physical capacity and physical activity. The study group consisted of 301 students in upper secondary school, 191 students in practical education (74 girls and 117 boys) and 110 students in theoretical education (57 girls and 53 boys). The adolescents were 16-19 years old and lived in southern Sweden. The study comprised three parts: a questionnaire, seven physical tests (one test to predict maximal oxygen uptake, three strength tests, two flexibility tests and one balance test) and information on each pupil's grades. Pupils in practical education for occupations like industrial- and building workers, mechanics, assistant nurses and hairdressers, all of which are occupations involving physical effort, had lower physical capacity than pupils in theoretical education among both girls and boys. A correlation was found between physical capacity and grades.

Adult height and menarcheal age of young women in Greece

Several factors contribute to the attainment of adult height, including genetic and environmental variables. To assess the relationship between menarcheal age and adult height, measured height was regressed on recalled menarcheal age in 286 young women, 18-24 years old, candidates for recruitment in the Greek army. Height was significantly associated with menarcheal age (b = 0.52, 95% CI = 0.04-1.00, p = 0.03). Joint evaluation of age, body mass index (BMI) and menarcheal age as predictors of final height revealed that only age at menarche represents an independent predictor of final height. Finally, education in completed years of schooling and place of birth or residence did not influence adult height, and no interaction between age at menarche and these factors was observed in the present study. These data suggest that adult height of Greek women is independently associated with menarcheal age, whereas BMI, place of birth or residence and educational level do not seem to play a role of comparable significance.

Short stature as an effect of economic and social conditions in childhood

Only a few studies on the effect of environmental factors on height are based on adults and none, that we could find, relates adult height to both economic and psycho-social conditions in childhood. The aim of this study is to investigate whether four indicators of economic and psycho-social conditions during childhood are related to a variation in adult height and whether these factors can explain the variation in height between men and women from different childhood classes. The study is based on data derived from a study of living conditions in Sweden conducted in 1991. Beside childhood socio-economic group, indicated by father's occupation, we employ four indicators of economic and psycho-social conditions during the childhood period, previously employed elsewhere. These are economic hardship, large family, dissension in the family and disunited family during childhood. The prevalence of short stature differs significantly by three of the four indicators on economic and psycho-social childhood conditions. It is also more common if the person has grown up in a disunited family, but this effect is not significant. The proportion of short persons also varied significantly by childhood socio-economic group. On the whole, short stature in adulthood seems to be a reflection of a number of adverse conditions in childhood, both economic, status related and psycho-social, and can, consequently, be seen as summing up the whole childhood period rather than merely reflecting differences in nutrition or any other specific condition.

Social inequality in height. A comparison between 10-year-old Helsinki and Stockholm children

The height of children may be used to indicate social inequality. The aim of this study was to analyze the difference in height of the socially more and less privileged 10-year-old Helsinki children in 1963 and 1991 and to compare the social gap to the corresponding gap in 1943, 1963 and 1991 in previous studies of Stockholm children. The difference in mean height of the Helsinki boys in 1963 was 4.5 cm (p < 0.001) and for girls 4.4 cm (p < 0.001). In Stockholm the corresponding differences in 1963 were negligible. Twenty years earlier (in 1943) it was 3.2 cm (p < 0.001) in Stockholm. In 1991 the difference was 1.4 cm (p < 0.05) for boys and 0.6 cm (n.s.) for girls in Helsinki, equivalent to the findings of the Stockholm children at the same time. The well-off Helsinki children already in 1963 were as tall as the Stockholm children. Thus, the decrease of the social gap in height from 1963 to 1991 in Helsinki seems to be mainly due to an increase in height of the socially less privileged children, exactly what was previously found for the Stockholm children between 1943 and 1963. Would the time for the equalization of height mirror the time for the development of the welfare states in Finland and Sweden respectively?

Early-life risk indicators of gastric cancer. A population-based case-control study in Sweden

Exposures early in life seem to play an important role in the development of gastric cancer, but their nature is not well understood. In a population-based case-control study, we examined weight, height and body-mass index (BMI) at the age of 20 as well as indices of socioeconomic conditions. Face-to-face interviews were conducted with 338 of 456 eligible histologically confirmed gastric cancer patients and 679 of 880 eligible control subjects, sampled from population registers and frequency matched by age and gender. Gastric cancer risk was negatively associated with height. Risk was positively, associated with weight at age 20 in both sexes. The highest BMI-quartile was associated with an increased risk. This association between BMI and risk was confined to BMI at age 20, and disappeared for BMI 20 years prior to interview. High socioeconomic status (SES) as well as long education carried a decreased risk of gastric cancer. Number of siblings was positively associated with risk. Factors related to short stature and high adolescent body weight are associated with an increased risk of gastric cancer, as is a high number of siblings. These factors may reflect influences of dietary patterns early in life.

Height, body mass index and mortality: do social factors explain the association?

The aim of the study was to analyse the effects on mortality of body height and body mass index (BMI) in young men, taking into account social and behavioural characteristics in early youth. The study is a 20-year follow-up of all Swedish men (n = 50,465) conscripted for military service in 1969-70. Baseline data on body height and weight as well as interview and questionnaire data on social and behavioural characteristics were linked to mortality data up to the end of 1988. Nine hundred and forty-six men died during the follow-up. We found a significant increase in mortality by decreasing body height; persons below 165 cm had an almost twofold increased mortality compared with those of average height. This association was reduced to the limit of statistical significance when we controlled for social and behavioural characteristics in a multivariate model. Persons with a BMI above 30 had a more than twofold increased mortality compared with those of average BMI. This association remained highly significant in a multivariate model. We thus confirmed previous findings of an inverse association between body height and mortality, but found that this association was almost entirely due to social background factors. The independent association between BMI and mortality may indicate a stronger genetic influence on BMI than on body height.

Childhood environment, intergenerational mobility, and adult health--evidence from Swedish data

STUDY OBJECTIVE

The aim was to examine whether body height is associated with intergenerational social mobility, and to determine the importance of intergenerational mobility for adult health.

DESIGN

Information from a survey conducted by Statistics Sweden on a randomly selected sample was supplemented with mortality data during a six year follow up.

PARTICIPANTS

The sample was identified in 1980-81 and comprised 14,757 persons aged 16-74 years. The non-response rate was 14%. In the current study a subsample of 9203 persons aged 30-74 years at the time of the interview was used.

MEASUREMENTS AND MAIN RESULTS

Information on adult height, socioeconomic status during childhood and in adult life, self perceived general health, and self reported longstanding illness at the time of the interview was supplemented with mortality data during the follow up period. The direction of the intergenerational mobility was defined as upward mobility, downward mobility, and no intergenerational mobility. The chances of falling into each of these three groups for tall, medium, and short persons were compared. The three mobility groups were also compared with regard to general health, longstanding illness and early death. The tall third of the sample was upwardly mobile to a larger extent than the short third, while the short third was more likely to be downwardly mobile. The upwardly mobile group perceived their health as bad much less than was expected. It also included a smaller number of persons with longstanding illness. Mortality, however, was not lower in this group.

CONCLUSIONS

Childhood environment influences height, height is linked to upward mobility, and upward mobility is linked to better health. This is one way in which childhood environment has an impact on adult health.

The good body: when big is better

An important cultural question is, "What is a 'good'--desirable, beautiful, impressive--body?" The answers are legion; here I examine why bigger bodies represent survival skill, and how this power symbolism is embodied by behaviors that guide larger persons toward the top of the social hierarchy. bigness is a complex concept comprising tallness, boniness, muscularity and fattiness. Data show that most people worldwide want to be big--both tall and fat. Those who achieve the ideal are disproportionately among the society's most socially powerful. In the food-secure West, fascination with power and the body has not waned, but has been redefined such that thinness is desired. This apparent anomaly is resolved by realizing that thinness in the midst of abundance--as long as one is also tall and muscular--still projects the traditional message of power, and brings such social boons as upward mobility.

Changes in body height among selected ethnic groups

STUDY OBJECTIVE

The aim was to assess the effects of genetic factors and environmental influences on adolescence body height.

DESIGN

The study was a retrospective survey of mean standing height collected from computerised medical draft records of 17-18 year old adolescents, born between 1950 and 1971.

SETTING

All the studied population is resident of the state of Israel.

PARTICIPANTS

About half a million records of recruits were examined. The sex distribution was: 61% male, 39% female. Ethnic distribution of the studied population was according to the countries of origin: Poland 7.8%, Romania 22.0%, Yemen 11.4%, Iraq 17.5%, Morocco 27.4%, and Israel 7.8%.

MEASUREMENTS AND MAIN RESULTS

Marked differences in standing height measures were found between the ethnic groups compared to the Israeli reference group. A linear increase of 1.1 mm/year for reference males and 0.8 mm/year for the female population was found over the 22 years of study period. Ethnic groups with lower mean height were found to have a significantly greater increase in height during the period studied.

CONCLUSIONS

Israel as an immigration country may serve as a model for the study of environmental and genetic factors. Under conditions found in Israel, body height continues to increase with year of birth, while significant differences in height between ethnic groups has diminished.

Childhood conditions and adult height

Self-reported height and childhood conditions among 1711 Danish male general workers born between 1923 and 1940 were analysed. No significant associations were found between adult height and father's occupation, growing up with both parents, paternal unemployment, sickness among the parents, parents receiving disability pension, economical problems in childhood, area of residence in childhood, and years at school. The study therefore provides no support for the hypothesis that poor childhood conditions are the cause of low adult height in this socially very homogeneous sample.

Causal explanations for class inequality in health--an empirical analysis

One of the most important issues for research on social class inequalities in health are the causes behind such differences. So far, the debate on class inequalities in health has mainly been centred around hypotheses on artefactual and selectional processes. Although most contributors to this branch of research have argued in favour of causal explanations, these have gained very little systematic scrutiny. In this article, several possible causal factors are singled out for empirical testing. The effect of these factors on class differences in physical and mental illness is studied by means of logit regressions. On the basis of these analyses, it is shown that physical working conditions are the prime source of class inequality in physical illness, although economic hardship during upbringing and health related behaviours also contribute. For class inequality in mental illness these three factors plus weak social network are important. In sum, a large part of the class differences in physical as well as mental illness can be understood as a result of systematic differences between classes in living conditions, primarily differences in working conditions.

Lack of class variation in health in adolescence: an artefact of an occupational measure of social class?

We have previously shown, using a wide range of health measures, that there is little evidence of consistent class gradients in health in adolescence. This paper examines the possibility that those findings were an artefact of the measure of class used. Seven indicators of health, development and functioning are investigated using six different occupationally-based and five non-occupationally based measures of socio-economic status. The results do not alter the conclusion of the earlier paper, namely that in adolescence class gradients are not consistently apparent in most indicators of health.

Adult body height, self perceived health and mortality in the Swedish population

STUDY OBJECTIVE

The purpose of the study was to examine adult body height as an indicator of general health.

DESIGN

The study was a survey of a randomly selected sample of the adult Swedish population obtained by the Swedish National Central Bureau of Statistics.

PARTICIPANTS

The sample studied was identified in 1980-81 and comprised 14,757 persons aged 16-74. Of these, 12,695 (86%) consented to interview.

MEASUREMENTS AND MAIN RESULTS

Information was obtained on adult height, socioeconomic status in childhood and adult life, self perceived health, self reported longstanding illness, and mortality during a six year follow up. The numbers of people in three height groups who considered their general health as bad, who reported any longstanding illness or who died during the follow up were compared with the expected numbers in the same groups. The number of persons with reduced health and the number of deaths was larger than expected in the shortest height group. The excess risk of dying in the shortest group (about 20% higher compared to the tallest group) was reduced but not eliminated when present and childhood socioeconomic group was taken into account. Coronary heart disease mortality in particular was linked to height. The shortest group of men and women reported the largest proportion with bad general health and longstanding illness. For the latter the differences between height groups disappeared after controlling for present socioeconomic status.

CONCLUSIONS

There is a detectable excess risk of morbidity and mortality from being short. Assuming that the childhood environment is an important determinant of adult stature it is also important for adult health.

Height and social class in middle-aged British men

A study of 7735 middle-aged British men drawn from general practices in twenty-four towns shows that there has been a progressive increase in mean height in the men who were born between 1919 and 1939. This is true for both manual and non-manual classes, but the mean heights of the two groups are significantly different and remain widely separated over this period of time. Manual workers lag twenty years behind non-manual workers in their attained height. Data from other studies indicate that this social class difference in adult height is still present in those born up to 1960. The variation in mean height between the twenty-four towns is less marked than the variation in mean height between the social classes. After social class and age have been taken into account, a "town effect" on height is still present. If height is accepted as an indicator of socio-economic circumstances in childhood, then there is a difference in adult height between social class groups in Great Britain which does not appear to be diminishing.

A review of the social patterning and significance of measures of height, weight, blood pressure and respiratory function

This paper reviews evidence about the social patterning and relationship to life chances of four measures of health, development or functioning; namely height, weight, blood pressure and respiratory function. It argues that these are useful supplements to more commonly used measures of 'health' such as mortality rates, morbidity rates, or self reports of health, and recommends the increased use of such direct physical measures in routine statistics and special health surveys.