Childhood adversities experienced by working-aged coronary heart disease patients
Introduction
It has been reported that increasing numbers of various work stressors and divorce are associated with total and cardiovascular mortality among men [1]. Some stressors (abuse history, lifetime traumas, turmoil in childhood family, and recent stressful life events) have been found to be related to poor health status [2]. In addition, emotional disturbance has been found to be a significant risk factor for coronary heart disease (CHD; [3]). Genetic factors have a significant role, but behaviours bear a complex relationship to the onset, maintenance, and progression as well as elimination of cardiovascular risk factors [4]. Even a dose–response relation of adverse childhood events, such as abuse, neglect, and household dysfunction, to ischemic heart disease has been found [5].
Traumatic events are without dispute associated with CHD. We already know that economic problems during childhood are associated with current health, and the association of childhood social problems with health is, in fact, somewhat weaker and less consistent than that of economic problems [6]. However, social variation is seen in some CHD risk factors in young people [7], and furthermore, there are socioeconomic inequalities in cases of self-reported chest pain [8].
It is possible that life events during adulthood are consequences of the disease, but life events during childhood cannot be. However, we know very little regarding the way childhood adversities involving financial problems, conflicts in the family, alcohol problems, and matters of personal security are associated with CHD. We examined the issue from this point of view in a nationwide sample in Finland.
Section snippets
Material and methods
The Health and Social Support study (HeSSup) is a prospective study on the psychosocial health of the Finnish working-aged population. The HeSSup population consisted of a random sample of 52,739 individuals drawn from the Finnish Population Register in four age groups: 20–24, 30–34, 40–44, and 50–54. The survey was carried out by postal questionnaire during the year 1998. Forms were returned by 21,101 individuals (approximately 5000 in each age group), a response rate of 40.0% (42.7% in 20–24,
Results
The most common childhood adversities had been long-lasting financial difficulties in the family and someone in the family seriously or chronically ill (Table 3). Almost half of the CHD patients reported these. Among the controls, over 10 percentage points fewer reported the same.
One in three had experienced serious conflicts and someone in the family had problems with alcohol (Table 3). Among the controls, 7 to 8 percentage points fewer reported the same. One in five had often been afraid of
Discussion
The principal finding in this study was that CHD patients have experienced significantly more childhood adversities than did the general population. Life events include not only family problems but also financial problems and those concerning personal security. It is also noteworthy that some of the adversities seem to be associated specifically with CHD because they were almost independent of the traditional risk factors such as smoking, hypertension, and obesity. Nor did low education have a
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