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Your unpopularity in school could kill you: Study says shunned kids linked to 34% higher risk of heart issues

Heart disease risk in adult men and women increased by one-third for those who were unpopular among their classmates and peers as kids
UPDATED SEP 19, 2020
(Getty Images)
(Getty Images)

How popular children are among their classmates or peers may have an impact on their health several years later, suggest researchers who found that unpopular children are at a significantly higher risk of suffering from heart and blood vessel conditions as adults. Compared with boys and girls who are very popular (high peer group status), 13-year-olds who are not very popular with their classmates seem to be at significantly increased risk (33% to 34%) of developing circulatory system disease – which are conditions that affect the normal functioning of the heart and blood vessels in later life – in later life, indicates the study. This is after accounting for potentially influential family and school factors as well as adult mental health. 

“In this study, we were able to study the long-term implications of peer relationships and experienced marginalization for a specific outcome, that is, circulatory disease. The findings suggest that experienced peer rejection leaves detectable traces even in later adulthood. The data material used in the study is quite unique and utilizes a relatively long time span between the exposure (peer status) and outcome (circulatory disease). We were also able to rule out that a rich set of other conditions in child- and adulthood (such as socioeconomic conditions during childhood, behavioral problems, mental disorders, etc) distorted our findings,” study author Alexander Miething, sociologist and researcher at the Department of Public Health Sciences in Stockholm University, told MEA WorldWide (MEAWW).

According to Miething, the study, however, does not manage to find a definite answer to the question as to why low peer status is associated with the circulatory disease. “We hypothesize that the primary mechanisms involve health behaviors and psychosocial stress. A common dilemma in this kind of research is that we have the information we need to establish associations between conditions in childhood and health outcomes in adulthood, but we know quite little about whatever is happening in between. Future studies should examine the whole chain of events. For example, it is possible that experienced marginalization in childhood decreases the ability to establish and keep social relationships in adulthood, which poses a health risk too,” explains Miething. He adds, “Further research should also address the role of health behaviors in adulthood: our data lacked information on smoking in adulthood, which as well might be an important intervening factor in the relationship between peer status and circulatory disease.”

Circulatory system disease are conditions that affect the normal functioning of the heart and blood vessels. (Getty Images)

The findings

Childhood family circumstances and living conditions are important predictors of subsequent mental and physical health. But it is not entirely clear what impact peer group status might have. To explore this further, the team looked at whether peer group status among 13-year-olds might be associated with the risk of developing conditions in adulthood that affect the normal functioning of the heart and blood vessels, such as narrowed and hardened arteries and abnormal heartbeat or atrial fibrillation.

The analysis, published in BMJ Open, draws data from the Stockholm Birth Cohort Multigenerational Study (SBC Multigen), which includes everyone born in 1953 and resident in the greater metropolitan area of Stockholm in 1963. The health of 5,410 men and 5,990 women, whose peer group status was known at the age of 13, was tracked into their 60s, using data from inpatient care registers.

To gauge peer group status, the 13-year-olds were asked whom among their classmates they preferred to work with. Four categories were created: zero nominations (marginalised), 1 (low status), 2 or 3 (medium status), and 4 or more (high status). Information was also obtained on family factors, such as number and position of siblings, parental education and mental health, socioeconomic conditions, and school factors, such as intellect, academic performance, and any criminal behavior.

The researchers found that slightly more of the boys enjoyed high peer group status at the age of 13 (33% or 1,788) than did the girls (28.5% or 1,710). More of the girls were marginalized: 16% (940) versus 12% (652). The circulatory disease was more common among men than it was among the women: 18.5% (999) as compared to 11% (669). But peer-group marginalization at age 13 was linked with a considerably 33-34% higher risk of circulatory disease in adulthood in both sexes.

Slightly more of the boys enjoyed high peer group status at the age of 13 (33%) than did the girls (28.5%). (Getty Images)

While not statistically significant, a “graded association” was observed for girls: the less popular they were, the higher their risk of circulatory disease in adulthood. Girls who enjoyed medium to high peer group status were still at greater risk of circulatory disease in later life than their most popular classmates. “This study confirmed that childhood circumstances impose health effects in later life. Peer relations play an important role in children’s emotional and social development and may have considerable long-term implications on their health,” the findings state.

This is an observational study, and as such cannot establish cause, say authors. Childhood peer group status was examined at a single time point, and there was little information available about health and health behaviors from childhood into adult life, which may have skewed the findings. “But peer relations play an important role in children's emotional and social development and may have considerable long-term implications on their health. There is convincing evidence from neuroscience regarding how social relationships modulate neuroendocrine responses that subsequently affect the circulatory system, increasing the risk for stroke and cardiovascular diseases,” the investigators write.

According to Miething, the findings may help to understand why some people have a higher risk to develop circulatory diseases than others do. “Probably more important is the role of early intervention when children are in trouble – marginalized and rejected by peers. Although problematic experiences with peers do not automatically lead to health problems, children benefit from having caring and supportive parents. Parents represent a strong protective factor. No child should ever have to feel afraid, rejected, or neglected in school. An advice for children who experience this is: do not hesitate to talk with an adult whom you trust or contact a helpline for kids,” he told MEAWW.