CHILDHOOD CONDITIONS, SENSE OF COHERENCE, SOCIAL-CLASS AND ADULT ILL HEALTH - EXPLORING THEIR THEORETICAL AND EMPIRICAL RELATIONS

In order to expand our knowledge of how health inequalities are genera ted, a broader range of possible mechanisms has to be studied. Two mec hanisms of potential importance here are childhood conditions and sens e of coherence. Drawing on theoretical arguments and empirical finding s in these two research fields, a conceptual model of the relationship s between childhood conditions, sense of coherence, adult social class and adult health is presented. On the basis of this model, this paper sets out to analyse (1) the degree to which a low sense of coherence is based in childhood experiences, (2) the degree to which the impact of childhood conditions on adult health is mediated through sense of c oherence, and (3) the importance of sense of coherence for class diffe rences in ill health. The analyses are carried out on both cross-secti onal data (n = 4390) and panel data (n = 3773) from the Swedish Level of Living Surveys in 1981 and 1991. The analyses indicate that childho od family size and the experience of a broken home are unrelated to se nse of coherence later in life, while economic hardship has a small an d indirect effect, mediated via class position in adulthood. Only diss ension in the childhood family was found to have a direct, although fa irly modest, effect on sense of coherence. Furthermore, it is demonstr ated that sense of coherence does not mediate the effect of childhood factors on adult health. Rather, childhood conditions and adult sense of coherence appear to be complementary and additive risk factors for illness in adulthood. The results presented here also suggest that sen se of coherence may be a factor involved in the shaping of class inequ alities in health. (C) 1997 Elsevier Science Ltd.