Early Life Influences and Associations with Health and Social Outcomes

years. Methods: Distance, near, and stereo vision were assessed as part of a broader biomedical examination. Logistic, multinomial, and proportional odds ordinal logistic regression were used, as appropriate, to assess the association between these vision functions and both key early life influences and health and social outcomes in mid-adult life. Main Outcome Measures: Distance, near, and stereo acuities and health and social outcomes. Results: In mid-adult life, vision function (across the full spectrum of both type and level of function) is associated with unemployment resulting from permanent sickness, lower socioeconomic status, and poorer general health (for example, for blindness; odds ratios were 2.5, 2.6, and 1.2, respectively). Also, impaired visual functions in mid-adult life are associated with a low birthweight, being small for gestational age, maternal smoking in pregnancy, and markers of socioeconomic deprivation in childhood (for example, for impaired distance acuity; odds ratios were 1.4, 1.3, 1.02, and 1.1, respectively). Conclusions: Although relatively uncommon in working-age adults, impaired vision can have important adverse consequences, which highlights the value of investigating visual function in the broader context of health and social functioning. In addition, visual function in adult life may be influenced directly by key prenatal and childhood biological and social determinants of general health. Thus, application of life-course epidemiology to complex chronic ophthalmic diseases of adult life such as glaucoma or macular degeneration is likely to prove valuable in elucidating whether and how biological, social, and lifestyle factors contribute to the cause. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2009;116:1866–1871 © 2009 by the American Academy of Ophthalmology. It is recognized intuitively that normal vision is important to the lives of adults of working age, and thus to society at large. Nevertheless, there has been limited life-course research on the association of visual function (across the full spectrum of both type and level of function) and health and social outcomes in mid-adult life. Equally, there has been limited exploration of the influence on visual functioning of key early life biological and social determinants of health. From a contemporary and nationally representative population of 44-year-olds in Britain, the distribution of visual functions are reported together with their associations with health and social outcomes and with early life influences.