Background: Genetic and maternal prenatal environmental factors as well as the post-natal rearing environment may contribute to the association between childhood socioeconomic circumstances and later mortality. In order to disentangle these influences, we studied all-cause and cause-specific mortality in a cohort of adoptees, in whom we estimated the effects of their biological and adoptive fathers' social classes as indicators of the genetic and/or prenatal environmental factors and the post-natal environment, respectively.
Methods: In all 12 608 children born 1924-47 in Denmark who were placed early in life with adoptive parents were followed up for causes of death until 2000. Hazard ratios for paternal social class retrieved from adoption records were estimated using Cox regression models.
Results: Adoptees with biological fathers from higher social classes had a lower rate of mortality after their fifth decade of life, mainly due to a lower risk of cardiovascular, infectious, and respiratory diseases. Adoptive father's social class showed no clear relation with adoptee's mortality risk. The risk estimates for paternal social class were slightly attenuated after adjustment for adoptee's adult social class, which as expected was inversely related to mortality from both natural and external causes.
Conclusion: Genetic and/or prenatal environmental factors contribute to the development of the relation of paternal social class to mortality from natural causes later in adult life independently of the effect of own social class, whereas there is no evidence for such long-term effect of the rearing environment.