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Socioeconomic, educational, family, perinatal and developmental early life domains as predictors of obesity and hypertension comorbidity: findings from the 1970 British Cohort Study (BCS70)

Socioeconomic, educational, family, perinatal and developmental early life domains as predictors of obesity and hypertension comorbidity: findings from the 1970 British Cohort Study (BCS70)
Socioeconomic, educational, family, perinatal and developmental early life domains as predictors of obesity and hypertension comorbidity: findings from the 1970 British Cohort Study (BCS70)

Early life experiences can interact with each other and shape long-term health outcomes. To inform prevention strategies, we grouped early life risk factors into conceptual domains and investigated how exposures across five predefined early life domains predict the development of obesity and hypertension comorbidity in adulthood. This paper builds on a previously published conceptual framework which views early-life influences as multidimensional and interrelated. This framework guided the grouping of risk factors into five domains for analysis. The sample included 7858 participants in the 1970 British Cohort Study. The outcome was obesity (BMI ≥30) and hypertension (blood pressure > 140/90 mmHg or self-reported doctor’s diagnosis) comorbidity at age 46. Early life domains included: ‘prenatal to birth’, ‘developmental attributes’, ‘child education’, ‘socioeconomic factors’ and ‘family environment’. We conducted prediction analysis in three stages:(1) stepwise backward elimination to select variables for inclusion, (2) calculation of predicted risk scores, (3) multivariable logistic regression analysis including domain-specific risk scores, sex and ethnicity. We included potential adult predictors in the sensitivity analysis. The area under the curve (AUC) was 0.63 (95%CI 0.61-0.65). Including adult predictors increases the AUC to 0.68 (95%CI 0.66-0.70). Three early life domains - the family environment (OR 1.11, 95% CI 1.05-1.17), socioeconomic factors (OR 1.09, 95% CI 1.04-1.16), and education ability (OR 1.07, 95% CI 1.02-1.13) were predictors of obesity-hypertension comorbidity. Three early life domains predicted obesity-hypertension comorbidity. Interventions addressing these domains could reduce the burden of comorbidity.

Population health, childhood education, children, family environment, hypertension, obesity, socioeconomics
0958-1596
Stannard, Sebastian
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Owen, Rhiannon K.
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Berrington, Ann
bd0fc093-310d-4236-8126-ca0c7eb9ddde
Fraser, Simon
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Ziauddeen, Nida
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Hoyle, Rebecca
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Paranjothy, Shantini
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Alwan, Nisreen A.
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Stannard, Sebastian
0fbf5a1c-abab-4135-a8f9-c3c9f570aaea
Owen, Rhiannon K.
ac692db4-4735-4f3e-b8f7-9682a092f354
Berrington, Ann
bd0fc093-310d-4236-8126-ca0c7eb9ddde
Fraser, Simon
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Ziauddeen, Nida
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Hoyle, Rebecca
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Paranjothy, Shantini
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Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382

Stannard, Sebastian, Owen, Rhiannon K., Berrington, Ann, Fraser, Simon, Ziauddeen, Nida, Hoyle, Rebecca, Paranjothy, Shantini and Alwan, Nisreen A. (2026) Socioeconomic, educational, family, perinatal and developmental early life domains as predictors of obesity and hypertension comorbidity: findings from the 1970 British Cohort Study (BCS70). Critical Public Health, 36 (1), [2659481]. (doi:10.1080/09581596.2026.2659481).

Record type: Article

Abstract

Early life experiences can interact with each other and shape long-term health outcomes. To inform prevention strategies, we grouped early life risk factors into conceptual domains and investigated how exposures across five predefined early life domains predict the development of obesity and hypertension comorbidity in adulthood. This paper builds on a previously published conceptual framework which views early-life influences as multidimensional and interrelated. This framework guided the grouping of risk factors into five domains for analysis. The sample included 7858 participants in the 1970 British Cohort Study. The outcome was obesity (BMI ≥30) and hypertension (blood pressure > 140/90 mmHg or self-reported doctor’s diagnosis) comorbidity at age 46. Early life domains included: ‘prenatal to birth’, ‘developmental attributes’, ‘child education’, ‘socioeconomic factors’ and ‘family environment’. We conducted prediction analysis in three stages:(1) stepwise backward elimination to select variables for inclusion, (2) calculation of predicted risk scores, (3) multivariable logistic regression analysis including domain-specific risk scores, sex and ethnicity. We included potential adult predictors in the sensitivity analysis. The area under the curve (AUC) was 0.63 (95%CI 0.61-0.65). Including adult predictors increases the AUC to 0.68 (95%CI 0.66-0.70). Three early life domains - the family environment (OR 1.11, 95% CI 1.05-1.17), socioeconomic factors (OR 1.09, 95% CI 1.04-1.16), and education ability (OR 1.07, 95% CI 1.02-1.13) were predictors of obesity-hypertension comorbidity. Three early life domains predicted obesity-hypertension comorbidity. Interventions addressing these domains could reduce the burden of comorbidity.

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Accepted/In Press date: 10 April 2010
e-pub ahead of print date: 19 April 2026
Published date: 19 April 2026
Keywords: Population health, childhood education, children, family environment, hypertension, obesity, socioeconomics

Identifiers

Local EPrints ID: 511157
URI: http://eprints.soton.ac.uk/id/eprint/511157
ISSN: 0958-1596
PURE UUID: 87f6a4cb-d380-4531-a0dc-0c5433426d6a
ORCID for Sebastian Stannard: ORCID iD orcid.org/0000-0002-6139-1020
ORCID for Ann Berrington: ORCID iD orcid.org/0000-0002-1683-6668
ORCID for Simon Fraser: ORCID iD orcid.org/0000-0002-4172-4406
ORCID for Nida Ziauddeen: ORCID iD orcid.org/0000-0002-8964-5029
ORCID for Rebecca Hoyle: ORCID iD orcid.org/0000-0002-1645-1071
ORCID for Nisreen A. Alwan: ORCID iD orcid.org/0000-0002-4134-8463

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Date deposited: 05 May 2026 17:20
Last modified: 14 May 2026 02:01

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Contributors

Author: Sebastian Stannard ORCID iD
Author: Rhiannon K. Owen
Author: Ann Berrington ORCID iD
Author: Simon Fraser ORCID iD
Author: Nida Ziauddeen ORCID iD
Author: Rebecca Hoyle ORCID iD
Author: Shantini Paranjothy

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