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Programme","doi-asserted-by":"publisher","award":["733280"],"award-info":[{"award-number":["733280"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Public Health"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>Aims:Socio-economic conditions in early life are important contributors to cardiovascular disease \u2013 the leading cause of mortality globally \u2013 in later life. We studied coronary heart disease (CHD) and stroke in adulthood among people born out of wedlock in two historical periods: before and during World War II in Finland. Methods: We compared offspring born out of wedlock before (1934\u20131939) and during (1940\u20131944) World War II with the offspring of married mothers in the Helsinki Birth Cohort Study. The war affected the position of unmarried mothers in society. We followed the study subjects from 1971 to 2014 and identified deaths and hospital admissions from CHD and stroke. Data were analysed using a Cox regression, adjusting for other childhood and adulthood socio-economic circumstances. Results: The rate of out-of-wedlock births was 240\/4052 (5.9%) before World War II and 397\/9197 (4.3%) during World War II. Among those born before World War II, out-of-wedlock birth was associated with an increased risk of stroke (hazard ratio (HR)=1.44; 95% confidence interval (CI) 1.00\u20132.07) and CHD (HR=1.37; 95% CI 1.02\u20131.86). Among those born out of wedlock during World War II, the risks of stroke (HR=0.89; 95% CI 0.58\u20131.36) and CHD (HR=0.70; 95% CI 0.48=1.03) were similar to those observed for the offspring of married mothers. The p-values for interaction of unmarried\u00d7World War II were ( p=0.015) for stroke and ( p=0.003) for CHD. Conclusions: In a society in which marriage is normative, being born out of wedlock is an important predictor of lifelong health disadvantage. However, this may change rapidly when societal circumstances change, such as during a war.<\/jats:p>","DOI":"10.1177\/14034948211019792","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T16:06:35Z","timestamp":1622649995000},"page":"613-621","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular disease in people born to unmarried mothers in two historical periods: The Helsinki Birth Cohort Study 1934\u20131944"],"prefix":"10.1177","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7441-5714","authenticated-orcid":false,"given":"H. Maiju","family":"Mikkonen","sequence":"first","affiliation":[{"name":"Finnish Institute for Health and Welfare, Finland"},{"name":"Faculty of Medicine, University of Helsinki, Finland"},{"name":"Economic and Social History, University of Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minna K.","family":"Salonen","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare, Finland"},{"name":"Folkh\u00e4lsan Research Centre, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antti","family":"H\u00e4kkinen","sequence":"additional","affiliation":[{"name":"Economic and Social History, University of Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clive","family":"Osmond","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Unit, University of Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan G.","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Folkh\u00e4lsan Research Centre, Finland"},{"name":"Department of General Practice and Primary Health Care, University of Helsinki, Finland"},{"name":"Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore"},{"name":"Department of Obstetrics and Gynaecology, and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eero","family":"Kajantie","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare, Finland"},{"name":"Children\u2019s Hospital, Helsinki University Central Hospital and University of Helsinki, Finland"},{"name":"PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland"},{"name":"Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,5,31]]},"reference":[{"key":"bibr1-14034948211019792","volume":"390","author":"GBD 2016 Causes of Death Collaborators","year":"2017","journal-title":"Lancet"},{"key":"bibr2-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1151"},{"key":"bibr3-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2005.06.053"},{"key":"bibr4-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031210-101234"},{"key":"bibr5-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000228"},{"key":"bibr6-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2015-206547"},{"key":"bibr7-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3485-z"},{"key":"bibr8-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(02)00374-X"},{"key":"bibr9-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2012.01302.x"},{"key":"bibr10-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.02.019"},{"key":"bibr11-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.11.037"},{"key":"bibr12-14034948211019792","volume-title":"A life course approach to chronic disease epidemiology","author":"Ben-Shlomo Y","year":"2004","edition":"2"},{"key":"bibr13-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-306-48247-2_6"},{"key":"bibr14-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000536"},{"key":"bibr15-14034948211019792","unstructured":"Statistical Office of the City of Helsinki. Statistical yearbooks of the City Helsinki 1934\u20131948. Helsinki: City of Helsinki, 1934\u20131948."},{"key":"bibr16-14034948211019792","author":"Laurent H","year":"2017","journal-title":"PhD thesis, University of Helsinki, Finland"},{"key":"bibr17-14034948211019792","unstructured":"Statistical Office of the City of Helsinki. Table 32a Hospital births and midwife-assisted births among women living in Helsinki in 1936\u20131938. Statistical reviews 1936\u20131938, Healthcare, the latter part. Helsinki: Statistical Office of the City of Helsinki, 1944."},{"key":"bibr18-14034948211019792","volume-title":"The history of social welfare activity in the city of Helsinki","author":"Halila A"},{"key":"bibr19-14034948211019792","volume-title":"Pohjola 2. maailmansodan aikana [The Nordic countries in World War II]","author":"Soikkanen H","year":"1987"},{"key":"bibr20-14034948211019792","unstructured":"Statistical Office of the City of Helsinki. The rationing board. In: Annual reports 1943\u20131948 (latter parts). Helsinki: City of Helsinki, 1946\u20131954."},{"key":"bibr21-14034948211019792","unstructured":"Rautavirta K. Petusta Pitsaan: Ruokahuollon j\u00e4rjestelyt kriisiaikojen Suomessa [From bark bread to pizza \u2013 food and exceptional circumstances: reactions of Finnish society to crises of food supply). PhD thesis, University of Helsinki, Finland, 2010."},{"key":"bibr22-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7292.949"},{"key":"bibr23-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000254471.72186.03"},{"key":"bibr24-14034948211019792","volume-title":"Classification of occupations 1980","author":"Statistics Finland","year":"1981"},{"key":"bibr25-14034948211019792","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2010.549146"},{"key":"bibr26-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm254"},{"key":"bibr27-14034948211019792","volume":"12","author":"Pajunen P","year":"2005","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"key":"bibr28-14034948211019792","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjr.0000239466.26132.f2"},{"key":"bibr29-14034948211019792","volume-title":"Ihminen sodassa","author":"Junila M","year":"2006"}],"container-title":["Scandinavian Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14034948211019792","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14034948211019792","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14034948211019792","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:16:19Z","timestamp":1777695379000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14034948211019792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,31]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1177\/14034948211019792"],"URL":"https:\/\/doi.org\/10.1177\/14034948211019792","relation":{},"ISSN":["1403-4948","1651-1905"],"issn-type":[{"value":"1403-4948","type":"print"},{"value":"1651-1905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,31]]}}}