Causation and Selection in Health Behaviours
To increase our understanding of mechanisms producing health inequalities.
There is a strong relation between socio-economic position (SEP), health behaviours, and health outcomes but causal pathways are hard to disentangle. Social causation theories suggest that SEP drives changes in health behaviours that later have health consequences. From a social selection perspective, health outcomes depend on pre-existing differences in health behaviours that also generate SEP differences.
Follow-up studies of men and women exposed in early life to the Dutch Famine (‘Hunger Winter’) of 1944-1945 show that the long term impact of prenatal adversity is not limited to young adults but persists through late middle age and also affects mortality. This longitudinal design will be used to examine the impact over time of selected life course transitions that affect SEP and health behaviours, including marriage, family composition, employment, and retirement.
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- Heijmans BT, Tobi EW, Stein AD, Putter H, Blauw GJ, Susser ES, Slagboom PE, Lumey LH. Persistent epigenetic differences associated with prenatal exposure to famine in humans. Proc Natl Acad Sci U S A 2008;105(44):17046-9.
- Ekamper P, van Poppel F, Stein AD, Lumey LH. Independent and additive association of prenatal famine exposure and intermediary life conditions with adult mortality between age 18-63 years. Soc Sci Med 2014; 119: 232-239.
- Lumey LH, Ekamper P, Bijwaard G, Conti G, van Poppel F. Overweight and obesity at age 19 after pre-natal famine exposure. Int J Obes (Lond) . 2021 Aug;45(8):1668-1676.
- Bijwaard GE, Alessie R, Angelini V, Lumey LH. Physical and psychological health at adolescence and home care use later in life. PLoS One. 2021 Dec 8;16(12):e0261078.