Social background may predict skeletal problems.

Researchers investigating the impact of social and economic inequality on health have today (Tuesday 19 April) announced findings that children from more privileged backgrounds are taller and leaner than children from poorer backgrounds – but that it may leave them more susceptible to skeletal problems such as fractures or osteoporosis in later life.

In a project investigating bone development in children, researchers confirmed that social position is connected to height and weight, but that there was no relationship with bone mass. However, bone shape did appear to be affected, with children from a higher social position more likely to have longer, slender bones which could be more vulnerable to breaks and medical complications.

The study found that by age 10, children whose mothers were educated to degree level were, on average, 1.5cm taller than children whose mothers had no formal qualification. They were also, on average, 1kg lighter.

Children who lived in council owned property were found to be an average of 1.5 cm shorter than children who lived in privately owned housing.When height and weight were compared to maternal social class*, it was found that children whose mothers were grouped as ‘I’ were over a centimetre taller and 1kg lighter than children whose mothers were identified as belonging to the ‘V’ group.

Lead researcher Dr Emma Clark, a Wellcome Trust Clinical Research Fellow, explained:

“Our prime concern in this project was to explore how social inequalities contribute to health inequalities.

“We wanted to investigate bone mass in children, considering how that may relate to bone mass as they get older. Many people develop skeletal problems later in life, if we can identify contributory factors to this early on, then we should be better equipped to help avoid and manage such problems.

“Interestingly, although we found no overall relationship between social background and bone mass, there was a marked connection with bone shape, which may have important implications in terms of the risk of developing osteoporotic fractures in later life.”

“Most conditions and diseases have some form of social pattern, with a higher risk of disease in those with lower social position. This opens the door to a new focus for researchers and sets us a challenge to find out why bones seem to be an exception.”

Osteoporosis is a growing problem, it is estimated that in the UK there are 3 million sufferers and that each year 14,000 people die as a result of an osteoporotic hip fracture. The strain to the NHS is also growing with over £1.7 billion spent treating people with osteoporosis each year.**

The findings, which will be announced today at the British Society for Rheumatology annual conference, come from a 6 month study which looked at over 6,700 children recording their height, weight and bone mass, against social information – such as housing tenure, mothers and fathers highest educational qualification and employment.

All of the volunteers from this programme are part of the Avon Longitudinal Study of Parents and Children (ALSPAC) – also know as Children of the ‘90s - a groundbreaking programme that monitors the health and development of almost 14,000 children born between 1991 and 1992, and their families.

Dr Clark is planning to expand this area of work by examining the number of children who suffer broken bones and other skeletal problems, related to their social background.

She has been awarded the British Society for Rheumatology young investigator of the year ward for this work.

The average height and weight for a 10 year boy is 139.5 cm and 35.9 kg; for a 10 year old girl it is 138.8cm and 36.4 kg.***

ENDS

Media contact:

Mark Anderson, The Wellcome Trust

020 7611 8612 / m.anderson@wellcome.ac.uk

ALSPAC PR and Communications:

Nick Kerswell , Sally Watson or Anne Gorringe

011733 16731

Notes to editor:

* Based on the National Statistics Socio-Economic Classifications (NS-SEC) criteria.

** Statistics from the DoH – April 2005,

***DoH, Health survey for England 2002.

1.The Wellcome Trust is an independent research funding charity established in 1936 under the will of the tropical medicine pioneer Sir Henry Wellcome. The Trust’s mission is to foster and promote research with the aim of improving human and animal health and it currently spends over £400 million per annum.

2. ALSPAC - The Avon Longitudinal Study of Parents and Children (also known as Children of the 90s) is a unique ongoing research project based in the University of Bristol. It enrolled 14,000 mothers during pregnancy in 1991-2 and has followed most of the children and parents in minute detail ever since

3. The British Society for Rheumatology annual conference is taking place at the International Convention Centre, Birmingham, between 19 – 22 April 2005