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Debbie A. Lawlor, PhD, MPH, MBChB, George Davey Smith, DSc, MD and Shah Ebrahim, DM, MSc.

The authors are with the Department of Social Medicine, University of Bristol, Bristol, England.

Correspondence: Requests for reprints should be sent to Debbie A. Lawlor, PhD, MPH, MBChB, Dept of Social Medicine, Univ of Bristol, Canynge Hall, Whiteladies Rd, Bristol, UK BS8 2PR (e-mail: d.a.lawlor{at}bristol.ac.uk).

Objectives. We assessed the association between childhood socioeconomic status (SES) and coronary heart disease among postmenopausal women.

Methods. We conducted a cross-sectional analysis of 3444 women aged 60 to 79 years.

Results. There was an independent linear association between childhood and adult SES and coronary heart disease. The association between childhood SES and coronary heart disease was attenuated when we adjusted for insulin resistance syndrome, adult smoking, physical activity, biomarkers of childhood nutrition, and passive smoking.

Conclusions. The association between adverse childhood SES and coronary heart disease is in part mediated through insulin resistance, which may be influenced by poor childhood nutrition, and in part through the association between childhood SES and adult behavioral risk factors.

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