Does the primary school attended influence self-reported health or its risk factors in later life? Aberdeen Children of the 1950s Study.

BACKGROUND Adult health and its determinants are influenced by the environment in childhood. The school attended is known to affect the health behaviours of pupils while still at school. Little is known about the long-term influence of school attended on health. METHODS A total of 7,095 respondents (mean age 47 years) to a follow-up questionnaire who attended primary school in Aberdeen, UK, provided information on self-reported health; self-reported high blood pressure; GHQ-4; smoking status; alcohol intake; and obesity. Variance partition coefficients (VPCs) summarized the variation in adult health outcomes and behaviours across schools. Multilevel logistic regression was used to estimate the contribution of school to variation in the outcomes taking into account individual-level and school-level factors. RESULTS There was some variation across schools in the proportion of adults reporting poor self-rated health (VPC = 0.020) and smoking (0.019). Higher VPCs were found for factors potentially confounded with school: paternal social classes (I&II) (0.45) and gender (0.44). Age at leaving secondary education (0.28) and income (0.10) varied across schools. The effects of primary school diminished after adjusting for individual-level childhood risk factors. The further addition of adult risk factors attenuated these childhood effects. After full adjustment there was no effect of the primary school attended for high blood pressure, current smoking, alcohol intake, and obesity, and negligible effects for the other outcomes. CONCLUSIONS Contrary to our expectations, we found little evidence of any relationship between primary school and adult self-reported health or behaviour. This is surprising given the extent to which characteristics known to be associated with adult health were clustered within schools.