Socioeconomic gradients in cardiorespiratory disease and diabetes in the 1960s: baseline findings from the GPO study

Public Health. 2006 Aug;120(8):685-95. doi: 10.1016/j.puhe.2006.02.010. Epub 2006 Jul 7.

Abstract

Objectives: To describe the socioeconomic distribution of risk factors for cardiorespiratory disease and diabetes in employed women and men in the late 1960s.

Study design and methods: Cross-sectional data were collected from 3345 General Post Office (GPO) employees in London, via a questionnaire and clinical examination, between October 1966 and April 1967.

Results: Our occupational grade classification conformed to expected patterns of greater car ownership and gardening among higher-grade women and men, and greater height in higher-grade men (highest-lowest grade 175.0-170.7 cm, P<0.001). A strong inverse grade gradient in bronchitis (2.1-9.4%, P<0.001) and a strong positive gradient in FEV1 (3.10-2.58l, P<0.001) were observed in men, although smoking was less consistently associated with grade. There was no consistent inverse association between grade and any cardiovascular risk factor in either sex, but strong inverse gradients in prevalence of impaired glucose tolerance (IGT) (5.1-18.2%, P<0.001) and 2-h glucose (4.14-4.25 mmol/l, P<0.001) in non-diabetic men. Using car ownership as an alternative measure of socioeconomic position, findings in men were replicated for respiratory measures, IGT and 2-h glucose prevalence. Inverse gradients were additionally observed for blood pressure, cholesterol and electrocardiogram abnormalities.

Conclusions: The GPO study confirms existing evidence of socioeconomic gradients in respiratory risk factors and provides new evidence of gradients in risk factors for diabetes in men. Although there was no conclusive evidence of an occupational gradient in any cardiovascular risk factor, car ownership was a good indicator of lower risk in men. No socioeconomic gradients in cardiorespiratory or diabetic risk factors were observed in women.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / history*
  • Cross-Sectional Studies
  • Diabetes Mellitus / economics
  • Diabetes Mellitus / history*
  • Female
  • History, 20th Century
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Respiratory Tract Diseases / economics
  • Respiratory Tract Diseases / history*
  • Socioeconomic Factors