Influence of socioeconomic circumstances in early and later life on strokerisk among men in a Scottish cohort study

Background and Purpose-The purpose of the study was to investigate stroke r isk by socioeconomic measures. Methods-The analysis was based on a large cohort study of 5765 working men, from 27 workplaces in Scotland, who were screened between 1970 and 1973. S troke was defined as having a hospital admission with a main diagnosis of s troke or dying of stroke in the 25-year follow-up period. Results-There were 416 men who had a stroke. Men with manual occupations wh en screened, on first entering the workforce, men with manual occupations, and men whose fathers had manual occupations had significantly higher rates of stroke than men in the nonmanual categories. Men who left hull-time edu cation at age 16 years or under also had significantly higher rates of stro ke. Men living in more deprived areas had higher rates of stroke, but the r ates were not statistically significant. The most marked difference was in relation to father's social class, and although adjusting for risk factors for stroke attenuated the relative rates, men whose fathers were in manual social classes had higher relative rates of stroke than men whose fathers w ere in nonmanual classes (adjusted relative rate for father's social class III manual was 1.37 [95% CI 1.03 to 1.81] and for father's social class IV or V was 1.46 [1.09 to 1.96]), Men who were upwardly mobile (father's socia l class manual, own social class nonmanual) had a rate of stroke similar to that of stable manual men. Conclusions-Poorer socioeconomic circumstance was associated with greater s troke risk, with adverse early-life circumstances of particular importance.