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Occupational social class, educational level and area deprivation independently predict plasma ascorbic acid concentration: a cross-sectional population based study in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk)


Objective: To investigate the independent association between three different measures of socioeconomic status and plasma ascorbic acid level.

Design: Cross-sectional population based study.

Setting and participants: 20 292 men and women aged 39–79 y who participated in the EPIC-Norfolk study.

Results: Individuals in manual social classes, who had no educational qualifications or those who lived in the most deprived areas had significantly lower levels of plasma ascorbic acid compared to those in nonmanual social classes, with at least O-level qualifications or who lived in less deprived areas. The magnitude of effect for each measure of socioeconomic status was greater in current smokers compared to current nonsmokers.

Conclusion: Education and social class were stronger predictors of differences in ascorbic acid levels, an indicator of dietary health behaviour, than a deprivation index based on the Townsend score. This suggests that education could be particularly important in influencing large socioeconomic differentials in health related behaviours and potentially, health outcomes in the UK.

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We thank the participants and general practitioners who took part in the study and the staff of EPICNorrfolk. EPIC-Norfolk is supported by research programme grant funding from the Cancer Research Campaign and Medical Research Council with additional support from the Stroke Association, British Heart Foundation, Department of Health, Europe Against Cancer Programme Commission of the European Union, Food Standards Agency and Wellcome Trust.

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Competing interests: none.

Contributors: KTK, ND, SB and NW are principal investigators in the EPIC-Norfolk population study. AW and SB are responsible for the dietary measurements and analyses. RL is responsible for data management and computing and data linkages for post coding. SS conducted the data analyses and wrote the paper with KTK with contributions from other co-authors.

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Correspondence to S Shohaimi.

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Shohaimi, S., Bingham, S., Welch, A. et al. Occupational social class, educational level and area deprivation independently predict plasma ascorbic acid concentration: a cross-sectional population based study in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk). Eur J Clin Nutr 58, 1432–1435 (2004).

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  • plasma ascorbic acid
  • social class
  • education, area deprivation
  • smoking

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