Portal de Periódicos da CAPES

Editorial Produção Nacional Revisado por pares

BIBTEX RIS

Who, and what, causes health inequities? Reflections on emerging debates from an exploratory Latin American/North American workshop

2010; BMJ; Volume: 64; Issue: 9 Linguagem: Inglês

10.1136/jech.2009.106906

1470-2738

Nancy Krieger, M. Alegria, Naomar de Almeida Filho, J. Barbosa da Silva, Maurício L. Barreto, Jason Beckfield, Lisa Berkman, Anne‐Emanuelle Birn, Bruce Bartholow Duncan, Saúl Franco, Diogo Anastácio Garcia, Sofia Gruskin, Sherman A. James, Asa Christina Laurell, M. I. Schmidt, Kerri L. Walters,

Global Health Care Issues

Objective: To examine the associations between childhood socioeconomic and family circumstances, health and behavioural and cognitive development, and health and mental well-being outcomes in adulthood; exploring whether associations are different for cohorts born in 1958 and 1970, or for men and women. Design: Pooled analysis of two prospective, population-based, British birth cohort studies. Participants: 11 327 men and women born in 1958 and 11 177 men and women born in 1970 who responded in the adult follow-up investigations at ages 33 and 30 respectively. Main outcome measures: Self-rated general health, Rutter malaise scale indicating mental well-being, and presence of a long-standing illness limiting daily activities; assessed at ages 33 and 30 for the 1958 and 1970 birth cohorts respectively. Results: A diversity of family background (socioeconomic deprivation, housing tenure, family disruption and parental interest), health and development (cognition and behaviour) measures each provided powerful independent indications for general health and mental well-being. Indications for limiting long-standing illness in adulthood were focused most strongly upon health difficulties in childhood. Few interactions between either birth cohort or gender and childhood measures were observed, and excepting these interactions consistency in associations between the childhood measures and the outcomes by gender and cohort was observable. Conclusions: This study emphasises the importance of cognitive and behavioural development in childhood, as well as deprivation, family background and childhood health in indicating future adult health and mental well-being, emphasising time-persistent effects and important indications for men and women.