Childhood Unpopularity May Increase Risk of Cardiovascular Disease in Adulthood

A recent prospective cohort study from Stockholm, Sweden indicates that social marginalization in late childhood may result in a heightened likelihood of circulatory problems in adult life. Across approximately 11,000 subjects studied in the Stockholm Birth Cohort Multigenerational Study (SBC Multigen), Stockholm University Department of Public Health professors Alexander Miething and Ylva Brännström Almquist found that lower peer status at age 13 significantly increased risk of circulatory problems in both men and women (Miething and Almquist, 2020).

Cardiovascular and circulatory disease have become the deadliest killers of the modern age. These terms refer to any defect concerning the heart or blood vessels, and encompass heart attacks (myocardial infarctions), high blood pressure (hypertension), strokes (cerebrovascular accidents, or CVAs), plaque in the arteries (atherosclerosis), hardening of the arteries (arteriosclerosis), and other afflictions. These diseases crowd the list of most common causes of death; heart disease and strokes are the first and fifth leading causes of death in the US respectively, and ischemic heart disease and stroke were the top two killers worldwide in 2016 per the World Health Organization (CDC, 2020; WHO, 2018).

Though family life in childhood has long been considered a reliable predictor of adulthood health, this study aimed to illuminate the lesser-known impacts of children’s peer relationships. Childhood data was extracted from the SBC Multigen, a study that tracked all people who were both born in 1953 and lived in the Stockholm metropolitan area in 1963 (Almquist et al., 2019). Peer status was determined by asking members of a school class who they preferred collaborating with, and the number of endorsements each student received from their peers was used as a measure of status (Miething and Almquist, 2020). Adult-stage cardiovascular data was collected for these same individuals from inpatient records (BMJ, 2020).  

The data revealed that subjects who were in low-status positions in childhood peer groups had a 33-34 percent higher risk for circulatory disease than those who were in higher-status positions (Miething and Almquist, 2020). For females, researchers detected a graded relationship between peer status and circulatory disease risk — more severe childhood unpopularity corresponded with a higher probability of cardiovascular illness. Conversely, researchers observed a threshold effect for male subjects, meaning that a heightened risk of circulatory disease was only found in those in the lowest childhood social strata (Miething and Almquist, 2020).

Given the deadliness of cardiovascular illness, this research suggests an opportunity for crucial preventative medicine. The study cannot confirm a causal relationship between the two factors (peer status and onset of cardiovascular disease) due to its observational nature (BMJ, 2020).   Nonetheless, the results strengthen the notion that childhood experiences have significant consequences on adult health. While many schools already preach inclusivity and empathy to improve their student culture and happiness, they may now have a medical incentive to do so.