Early life conditions and trends in mortality at later life: is there any relationship?

Abstract

Mortality from Ischemic Heart Disease (IHD) ¹, stroke ^{2, 3}, and stomach cancer ^{4, 5} have fallen over recent decades, especially in developed countries; however, IHD and stroke remain among the leading causes of death in Europe ^{6, 7}. Furthermore, wide geographic variations in rates and trends of mortality from these diseases have been shown since the early 1950s ^{8, 9} and for incidence and case fatality from IHD by the WHO MONICA Project in the mid-1980s ¹⁰.

There is a controversy in the relationship between early life conditions and mortality at later life. Several studies have shown the association between IHD and adverse living conditions in early life ^11-15, but not always ^{16, 17}. For stroke, some studies have observed this relationship ^{14, 18}, whereas others have not ^{12, 15}. Time trends of stomach cancer also differ between populations and the role of living conditions on trends is not yet fully understood ¹⁹.

In this paper, the results of my previous population-based time-series studies will be discussed that aimed to describe trends in mortality between subsequent cohorts in relation to living conditions in early life of these cohorts ^{20, 21}. Cohort-wise trends of IHD, stroke, and stomach cancer mortality of populations in seven European countries –i.e., Denmark, England and Wales, Finland, France, the Netherlands, Norway and Sweden- have been assessed and it has been determined whether these trends were correlated with developments in infant mortality rate (IMR) at the time of birth of the subsequent cohorts.

Generally, an overall decline in mortality from these three diseases from 1950 to 2005 in all countries, for all ages and both men and women have been observed, with the important exception of a period epidemic of IHD in 1950 to 1970. From a cohort perspective, we observed steady declines for between cohorts born between 1860 and 1939 in most causes, again with the exception of IHD.

Key Words: Early life conditions, Mortality trends, Ischemic Heart Diseases, Stroke, Stomach cancer, Europe