Childhood Socioeconomic Circumstances and Adult Mortality: A Systematic Review and Meta-Analysis
1
School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Introduction Childhood socioeconomic circumstances are important determinants of adult health, yet no systematic synthesis of their impact on adult mortality has been published since 2008. This study aimed to synthesise evidence on the associations between childhood socioeconomic circumstances and adult all-cause and cause-specific mortality, quantifying population-level impacts to inform global health equity policy. Methods We conducted a systematic review and meta-analysis of longitudinal cohort studies. We searched MEDLINE, SocIndex, ASSIA and ProQuest Public Health from inception to March 2025 without language restrictions. We included studies linking childhood socioeconomic conditions (parental occupation, education, economic circumstances, housing) to adult mortality (age 18 or older). Risk of bias was assessed using ROBINS-E and evidence certainty using GRADE. We pooled hazard ratios (HR) using restricted maximum likelihood random-effects models and calculated the relative index of inequality (RII) to standardise comparisons across socioeconomic hierarchies. Results The review included 99 studies comprising approximately 8.5 million participants from 18 countries, providing 484 effect estimates. Disadvantaged childhood socioeconomic circumstances were consistently associated with higher adult mortality. Comparing the most versus least disadvantaged groups for father's occupational social class yielded a pooled HR of 1.26 (95% CI 1.18 to 1.35), translating to 181 (95% CI 125 to 243) excess deaths per 100000 population per year. The relative index of inequality was greatest for childhood economic circumstances (RII 2.52; 95% CI 1.17 to 5.42). Harmful associations persisted across cause-specific outcomes, including cardiovascular disease (HR 1.28) and respiratory disease (HR 1.65 to 1.82), and remained consistent when restricted to studies with low risk of bias. Conclusions Disadvantaged childhood socioeconomic circumstances are robustly associated with increased adult mortality across diverse measures and geographic contexts. These findings support prioritising early-life interventions to improve population health and reduce mortality disparities
Introduction Childhood socioeconomic circumstances are important determinants of adult health, yet no systematic synthesis of their impact on adult mortality has been published since 2008. This study aimed to synthesise evidence on the associations between childhood socioeconomic circumstances and adult all-cause and cause-specific mortality, quantifying population-level impacts to inform global health equity policy. Methods We conducted a systematic review and meta-analysis of longitudinal cohort studies. We searched MEDLINE, SocIndex, ASSIA and ProQuest Public Health from inception to March 2025 without language restrictions. We included studies linking childhood socioeconomic conditions (parental occupation, education, economic circumstances, housing) to adult mortality (age 18 or older). Risk of bias was assessed using ROBINS-E and evidence certainty using GRADE. We pooled hazard ratios (HR) using restricted maximum likelihood random-effects models and calculated the relative index of inequality (RII) to standardise comparisons across socioeconomic hierarchies. Results The review included 99 studies comprising approximately 8.5 million participants from 18 countries, providing 484 effect estimates. Disadvantaged childhood socioeconomic circumstances were consistently associated with higher adult mortality. Comparing the most versus least disadvantaged groups for father's occupational social class yielded a pooled HR of 1.26 (95% CI 1.18 to 1.35), translating to 181 (95% CI 125 to 243) excess deaths per 100000 population per year. The relative index of inequality was greatest for childhood economic circumstances (RII 2.52; 95% CI 1.17 to 5.42). Harmful associations persisted across cause-specific outcomes, including cardiovascular disease (HR 1.28) and respiratory disease (HR 1.65 to 1.82), and remained consistent when restricted to studies with low risk of bias. Conclusions Disadvantaged childhood socioeconomic circumstances are robustly associated with increased adult mortality across diverse measures and geographic contexts. These findings support prioritising early-life interventions to improve population health and reduce mortality disparities
| eISSN: | 2654-1459 |
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