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Social Background May Predict Skeletal Problems

19 April 2005

One possible long term disadvantage of being born into a privileged family is highlighted by new research on the shape and size of today’s children.

One possible long term disadvantage of being born into a privileged family is highlighted by new research on the shape and size of today’s children.

Researchers investigating the effects of social inequality on health have today (Tuesday 19 April) released findings which show that children from more affluent backgrounds are taller and leaner than children from poorer families.

By the age of 9, children whose mothers were educated to degree level were, on average, 1.5cm taller than children whose mothers had no formal qualification. They were also, on average, 1kg lighter.

But when they examined the children’s bone mass, the researchers in Bristol found evidence that the taller, thinner (and more affluent) children may have weaker bones and be more susceptible to fractures or osteoporosis later in life.

The results are based on tests involving 6,700 children taking part in the University of Bristol’s Children of the 90s study. The findings will be announced today at the annual conference of the British Society for Rheumatology.

Lead researcher Dr Emma Clark, a Wellcome Trust Clinical Research Fellow, explained: “Our prime concern in this project was to explore how social inequalities contribute to health inequalities.

“We wanted to investigate bone mass in children, considering how that may relate to bone mass as they get older. Many people develop skeletal problems later in life, if we can identify contributory factors to this early on, then we should be better equipped to help avoid and manage such problems.

Bone mass was measured for all 6,700 children using a whole body DXA Lunar Prodigy scanner which can assess bone, lean and fat content.

The researchers discovered that while they may be taller and leaner, the children from more privileged backgrounds have the same amount of calcium in their bones as children from less privileged backgrounds.

There were strong differences in bone shape too. Children from more privileged backgrounds have taller more slender bones (despite having similar calcium content), which may make them break more easily.

Taken together, it suggests that children from more privileged backgrounds may have weaker bones and a higher susceptibility to sustaining fractures due to osteoporosis in later life.

Dr Clark says: “Most conditions and diseases have some form of social pattern. The fascinating fact is that bone mass shows no signs of this, while height and weight do. This opens the door to a new focus for researchers and sets us a challenge to find out why, and what the implications of this may be.

“It also raises the possibility that children with a bigger bone mass relative to their height are less susceptible to skeletal problems as they have stronger bones. This is something that needs to be considered further, but it is important to emphasise the role of a healthy diet and regular exercise in maintaining general good health and wellbeing.“

Dr Clark is planning to expand this area of work by examining the number of children who suffer broken bones and other skeletal problems, related to their social background.

She has been awarded the British Society for Rheumatology young investigator of the year ward for this work.

Academic paper reference

Emma M Clark, Andy Ness, Jon H Tobias (2005) Social Position Affects Bone Mass in Childhood Through Opposing Actions on Height and Weight. Journal of Bone and Mineral Research. Volume 20, Issue 12, pages 2082–2089, December 2005. doi: 10.1359/JBMR.050808


  • ALSPAC The Avon Longitudinal Study of Parents and Children (also known as Children of the 90s) is a unique ongoing research project based in the University of Bristol. It enrolled 14,000 mothers during pregnancy in 1991-2 and has followed most of the children and parents in minute detail ever since.
  • The ALSPAC study could not have been undertaken without Social background may predict skeletal problems the continuing financial support of the Medical Research Council, the Wellcome Trust, and the University of Bristol among many others.
  • The Wellcome Trust is an independent research funding charity established in 1936 under the will of the tropical medicine pioneer Sir Henry Wellcome. The Trust’s mission is to foster and promote research with the aim of improving human and animal health and it currently spends over £400 million per annum.
  • The British Society for Rheumatology annual conference is taking place at the International Convention Centre, Birmingham, between 19–22 April 2005


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