The Australian Aboriginal Birth Cohort study: socio‐economic status at birth and cardiovascular risk factors to 25 years of age

Abstract

Objectives To determine whether socio‐economic status at birth is associated with differences in risk factors for cardiovascular disease — body mass index (BMI), blood pressure, blood lipid levels — during the first 25 years of life. Design Analysis of prospectively collected data. Setting, participants 570 of 686 children born to Aboriginal mothers at the Royal Darwin Hospital during 1987–1990 and recruited for the Aboriginal Birth Cohort Study in the Northern Territory. Participants resided in 46 urban and remote communities across the NT. The analysed data were collected at three follow‐ups: Wave 2 in 1998–2001 (570 participants; mean age, 11 years), Wave 3 in 2006–2008 (442 participants; mean age, 18 years), and Wave 4 in 2014–2016 (423 participants; mean age, 25 years). Main outcome measures Cardiovascular disease risk factors by study wave and three socio‐economic measures at the time of birth: area‐level Indigenous Relative Socioeconomic Outcomes (IRSEO) index score and location (urban, remote) of residence, and parity of mother. Results Area‐level IRSEO of residence at birth influenced BMI (P < 0.001), systolic blood pressure (P = 0.024), LDL‐cholesterol (P = 0.010), and HDL‐cholesterol levels (P < 0.001). Remoteness of residence at birth influenced BMI (P < 0.001), HDL‐cholesterol (P < 0.001), and triglyceride levels (P = 0.043). Mother's parity at birth influenced BMI (P = 0.039). Conclusions Our longitudinal life course analyses indicate that area‐level socio‐economic factors at birth influence the prevalence of major cardiovascular disease risk factors among Indigenous Australians during childhood and early adulthood.

Socioeconomic status, remoteness and tracking of nutritional status from childhood to adulthood in an Australian Aboriginal Birth Cohort: the ABC study

“…This is in contrast to a study from New South Wales that examined Indigenous people aged 45 years and older, where participants from more advantaged and urban surroundings had lower prevalences of obesity and overweight than those from remote and disadvantaged areas 16. In a previous study from the ABC, a significant association was found between remoteness and areal disadvantage at birth and longitudinal development of BMI measured at the same follow-ups as the present study 33. It seems that the spatial trend in obesity in this cohort is similar to that traditionally seen in low-income and middle-income countries, where obesity is more concentrated in cities and wealthier regions and underweight is more common in remote and rural settings 1.…”

Potential Determinants of Cardio-Metabolic Risk among Aboriginal and Torres Strait Islander Children and Adolescents: A Systematic Review

“…Other maternal factors (two studies). In LSIC, higher maternal age was associated with higher BMI in preschool and childhood [ 58 ] and in ABC, higher maternal parity was associated with lower BMI during youth [ 46 , 47 ].…”

“…Overall, greater area-level SES was associated with higher obesity measures. In ABC and LSIC, higher BMI or levels of obesity were consistently seen among children and youth who were living in more advantaged areas at baseline [ 46 , 47 , 49 , 52 , 53 , 56 ]. For example, LSIC participants from areas with highest disadvantage had 80% lower odds of obesity in childhood compared to the least disadvantaged areas [ 56 ], and ABC participants from least disadvantaged areas had 91% lower odds of ideal BMI at 25 years of age compared to most disadvantaged areas [ 46 ].…”

Childhood Socioeconomic Status and Type 2 Diabetes Mellitus among Mid-late Chinese: A Structural Equation Modeling Analysis

“…Increasing studies have given insights into socioeconomic factors for the potential "longterm" effects on biological, psychological and behavioral factors of T2DM and attached great importance to childhood socioeconomic status (CSES) over the life course (3). Disadvantaged CSES 3 have been revealed as a salient predictor of later health, which is associated with majority chronic diseases occurring in mid-late adulthood such as cardiovascular disease (4), hypertension (5), functional limits (6), stroke (7) and cognitive impairment (8).…”