Work-family life courses and markers of stress and inflammation in mid-life: evidence from the National Child Development Study

Int J Epidemiol. 2016 Aug;45(4):1247-1259. doi: 10.1093/ije/dyv205. Epub 2015 Oct 14.


Background: This study investigated associations between work-family life courses and biomarkers of inflammation and stress in mid-life among British men and women. Gender differences in these associations were also explored.

Methods: A novel statistical method-multi-channel sequence analysis-defined work-family life courses between the ages of 16 and 42 years, combining annual information on work, partnership and parenthood. Associations between work-family life courses and inflammation [C-reactive protein (CRP), fibrinogen and von Willebrand factor] and cortisol at age 44/45 years were tested using multivariate linear regression using multiply-imputed data on almost 6500 participants from the National Child Development Study 1958 British birth cohort.

Results: Compared with those who combined strong ties to paid work with later transitions to stable family lives ('Work, later family' group), 'Teen parents' had higher CRP [40.6% higher, 95% confidence interval (CI): 5.6, 87.0] and fibrinogen (7.8% higher, 95% CI: 2.3, 13.5) levels, and homemakers ('No paid work, early family') had raised fibrinogen levels (4.7% higher, 95% CI: 0.7, 9.0), independent of childhood health and socioeconomic position, adult socioeconomic position, health behaviours and body mass index (BMI). Those who combined later transitions to stable family ties with a career break for childrearing had higher post-waking cortisol than the 'Work, later family' group; however, no associations were seen for other work-family types, therefore suggesting a null finding with cortisol. No statistically significant gender interactions in associations between work-family types and inflammatory or cortisol outcomes were found.

Conclusions: Work-family life courses characterised by early parenthood or weak work ties were associated with a raised risk profile in relation to chronic inflammation.

Keywords: National Child Development Study; cortisol; inflammation; life course; parenthood; partnerships; sequence analysis; work.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Child
  • Cohort Studies
  • Family Relations*
  • Female
  • Fibrinogen / analysis
  • Humans
  • Hydrocortisone / blood*
  • Inflammation / blood*
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Occupational Stress / psychology*
  • Risk Factors
  • Social Class*
  • United Kingdom
  • Work-Life Balance*
  • Young Adult
  • von Willebrand Factor / analysis


  • Biomarkers
  • von Willebrand Factor
  • Fibrinogen
  • C-Reactive Protein
  • Hydrocortisone