The causal effects of health conditions and risk factors on social and socioeconomic outcomes: Mendelian randomization in UK Biobank
Year: 2020
Type: article
Abstract: Background We aimed to estimate the causal effect of health conditions and risk factors on social and socioeconomic outcomes in UK Biobank. Evidence on socioeconomic impacts is important to understand because it can help governments, policy makers and decision makers allocate resources efficiently and effectively. Methods We used Mendelian randomization to estimate the causal effects of eight health conditions (asthma, breast cancer, coronary heart disease, depression, eczema, migraine, osteoarthritis, type 2 diabetes) and five health risk factors [alcohol intake, body mass index (BMI), cholesterol, systolic blood pressure, smoking] on 19 social and socioeconomic outcomes in 336 997 men and women of White British ancestry in UK Biobank, aged between 39 and 72 years. Outcomes included annual household income, employment, deprivation [measured by the Townsend deprivation index (TDI)], degree-level education, happiness, loneliness and 13 other social and socioeconomic outcomes. Results Results suggested that BMI, smoking and alcohol intake affect many socioeconomic outcomes. For example, smoking was estimated to reduce household income [mean difference = -£22 838, 95% confidence interval (CI): -£31 354 to -£14 321] and the chance of owning accommodation [absolute percentage change (APC) = -20.8%, 95% CI: -28.2% to -13.4%], of being satisfied with health (APC = -35.4%, 95% CI: -51.2% to -19.5%) and of obtaining a university degree (APC = -65.9%, 95% CI: -81.4% to -50.4%), while also increasing deprivation (mean difference in TDI = 1.73, 95% CI: 1.02 to 2.44, approximately 216% of a decile of TDI). There was evidence that asthma decreased household income, the chance of obtaining a university degree and the chance of cohabiting, and migraine reduced the chance of having a weekly leisure or social activity, especially in men. For other associations, estimates were null. Conclusions Higher BMI, alcohol intake and smoking were all estimated to adversely affect multiple social and socioeconomic outcomes. Effects were not detected between health conditions and socioeconomic outcomes using Mendelian randomization, with the exceptions of depression, asthma and migraines. This may reflect true null associations, selection bias given the relative health and age of participants in UK Biobank, and/or lack of power to detect effects.
DOI: 10.1093/ije/dyaa114
Institutions: University of Bristol, MRC Integrative Epidemiology Unit, Public Health Wales, University of Bath, University of Exeter, Royal Devon and Exeter Hospital, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Cardiff University, Norwegian University of Science and Technology
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,514
Awards: G1205690636, G149876332, G1643655829, G188017575, G2162646731, G235045266, G2452660645, G2459786267, Measuring and Analysing Socioeconomic Inequalities in Health, G2538597952, G2640153490, G2673957436, Evidence synthesis of diagnostic test performance from a decision-making perspective, G2833807808, G2957837340, G3227224082, G3233549029, G3297223890, G3770657026, G4001648953, Informing educational interventions using genome-wide data: causal evidence from 573,586 participants of eight cohort studies, G5001017760, G5070147214, G5231239147, G5470336846, G571894948, G5889604929, G6119919417, G6285097384, G6680420078, Mendelian randomization to hypothesis-free causal inference, Informing Healthy Public Policy, G7208770452, G7687343807, Mediation analysis in life course epidemiology: methodological innovation and application to studies of obesity and cardiometabolic health, G7990456425, Improving evidence for economic evaluation and healthcare policy in relation to long term conditions using Mendelian Randomization on large cohorts, G8502142660, G8518790725, G8575094079, G8989501819
OpenAlex ID: W3027080948