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Could injury risk be predetermined?
  1. M E J Wadsworth
  1. Director of the MRC National Survey of Health and Development, Department of Epidemiology and Public Health, University College London Medical School, 1–19 Torrington Place, London WC1E 6BT

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Since Rowntree's paper, this issue's Classic (69), was published the 5362 children, born in 1946, who were its target population, have been studied repeatedly throughout the intervening years. This, the National Survey of Health and Development, is the first of several British birth cohorts to have been studied systematically. At the most recent data collection, in 1989, 3854 men and women from that original population were alive (7% had died), were living in Britain (11% lived abroad), and had not refused cooperation (10% were refusals). Of that population 85% gave information at age 43 years.1, 2

At the beginning of this long term study Rowntree concluded that social factors were of little consequence for injury, but that developmental factors were of considerable significance. In the subsequent years of the study these same developmental factors have also proved to have significant predictive value for other aspects of physical health in later life. Poor development in terms of birth weight, or height and weight gain in the first four years of life, were independently asssociated with raised blood pressure at 36 and 43 years, and with poor respiratory function and raised risk of chronic obstructive pulmonary disease. …

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