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15-05-2012 | Bone health | Article

Socioeconomic status has lifelong influence on bone health


Free abstract

MedWire News: Socioeconomic status (SES) in both childhood and adulthood are associated with bone mineral density (BMD), independently of other factors, research indicates.

The data point to measures such as financial status and education as having an important and enduring influence on bone mass over the entire life course.

Carolyn Crandall (David Geffen School of Medicine, University of California at Los Angeles, USA) and colleagues analyzed data on 729 adults included in the MIDUS National Study of Health and Well-Being.

Participants were aged between 25 and 75 years at recruitment in 1995-1996 and were re-interviewed 9-10 years later. At both visits, participants were assessed for SES and bone mineral density.

The average age of participants at baseline was 56.9 years, 23.6% were Black, and 51.6% were women.

Crandall's team assigned to each participant three indicators of SES status: a "childhood SES advantage score" based on parental education level, self-rated financial status relative to others, and whether or not they had been on welfare; the highest level of education attained; and an "adult current financial advantage score" based on poverty-to-income ratio, self-assessed current financial situation, and ability to meet needs and pay bills.

Writing in Bone, the team reports that both childhood advantage score and adult education level were positively associated with lumbar spine BMD, after adjustment for race, study site, body weight, menopausal status, and age.

Specifically, lumbar spine BMD rose by 0.011 g/cm2 for each 1-point increment in childhood advantage score, and was 0.047 g/cm2 higher in participants with a Bachelor's degree or higher than in people with no college education.

These associations persisted after further adjustment for health behaviors such as lifetime exposure to smoking, alcohol consumption, and physical activity, note the authors.

Neither childhood advantage score nor adult education level were associated with femoral neck BMD, however, and adult current financial advantage score was not statistically significantly associated with BMD at either site.

Noting that adult bone mass "is a function of bone acquisition in childhood and decline in adulthood," Crandall et al conclude: "[L]ife-course, and especially childhood socioeconomic factors, may influence the acquisition of bone mass, especially trabecular bone mass, during the growing years."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Joanna Lyford

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