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Basic information

Project name: "Developmental origins of health inequality – maternal influences, growth in early life, reproduction, and health in adulthood. The Uppsala Birth Cohort Multigeneration Study (UBCoS)"
Manager: Ilona Koupil
Period: 2004-01-01 - 2017-12-31
Funded by: Swedish Council for Working Life and Social Research and the Swedish Research Council


Health inequalities and social determinants of health are a cause of much concern in all societies today. The Uppsala Birth Cohort Multigeneration Study (UBCoS Multigen) was recently established at the Centre for Health Equity Studies and offers a unique opportunity to explore several issues highly relevant for health equity research. The uniqueness of our study is mainly in the possibility to apply a life-course approach to analysis in a cohort with detailed biological and social data stretching from birth to old age, and in being able to extend the transgenerational perspective to more than two successive generations.


Our main research objectives are to:
(i) Address questions of the extent to which and the mechanisms whereby social advantage and disadvantage are transmitted from one generation to the next, giving rise to continuity in social disadvantage both over the life cycle and across generations.
(ii) Explore how early social and biological factors, especially those related to cardiovascular risk, are transmitted from the parent generation to offspring generation(s).
(iii) Try to integrate the understanding of broader social mechanisms with the understanding of disease specific aetiology to answer the question of how, and to what extent, health inequalities are reproduced into each new generation.
Within this project, we hope to shed light upon some very specific mechanisms how health inequalities are formed over the life-course and regenerated in each new generation. In addition, we hope to be able to inform policy makers about factors that have a long term influence on educational attainment and health, offering new insights for prevention, health promotion and equity in educational attainment.

Study design

This unique multigenerational study started in 2005 when we were first able to combine existing data on a representative and well-defined cohort of 14,192 males and females born in Uppsala from 1915-1929 (the Uppsala Birth Cohort: UBCoS) with information on descendants of the original cohort members obtained from routine registers. In 2007-2011, the data set was further developed by additional data collection in school archives and records from Census 1930 and the period of follow-up was extended till end of year 2009. The study is unique in investigating intergenerational effects as "forward in time" processes, starting at the beginning of the last century (i.e. well before any of the routine registers were in place). Intergenerational associations can be currently investigated in more than 140,000 study subjects from families spanning up to five generations, including the 14,192 original cohort members, their 22,559 children, 38,771 grandchildren and 25,471 great grandchildren born up to 2009. The aim of the study is to investigate life course and intergenerational determinants of social inequalities in health.

For further information or inquiries about access to data please contact the principal investigator Professor Ilona Koupil at

Recent publications

From cradle to grave: tracking socioeconomic inequalities in mortality in a cohort of 11 868 men and women born in Uppsala, Sweden, 1915-1929. 
Juárez SP, Goodman A, Koupil I. J Epidemiol Community Health. 2016 Jan 5. pii: jech-2015-206547. doi: 10.1136/jech-2015-206547. 

Maternal pelvic size, fetal growth and risk of stroke in adult offspring in a large Swedish cohort. 
Heshmati A, Chaparro MP, Koupil I. J Dev Orig Health Dis. 2016 Feb;7(1):108-13. doi: 10.1017/S2040174415007254.

The impact of parental educational trajectories on their adult offspring's overweight/obesity status: a study of three generations of Swedish men and women.
Chaparro MP, Koupil I. Soc Sci Med. 2014 Nov;120:199-207. doi: 10.1016/j.socscimed.2014.09.024. Epub 2014 Sep 16.

Early life conditions, partnership histories, and mortality risk for Swedish men and women born 1915-1929.
Donrovich R, Drefahl S, Koupil I. Soc Sci Med. 2014 May;108:60-7. doi: 10.1016/j.socscimed.2014.02.036. Epub 2014 Feb 24.

Socio-economic position over the life course and all-cause, and circulatory diseases mortality at age 50-87 years: results from a Swedish birth cohort.
Mishra GD, Chiesa F, Goodman A, De Stavola B, Koupil I. Eur J Epidemiol. 2013 Feb;28(2):139-47. doi: 10.1007/s10654-013-9777-z. Epub 2013 Feb 23.

Low fertility increases descendant socioeconomic position but reduces long-term fitness in a modern post-industrial society.
Goodman A, Koupil I, Lawson DW. Proc Biol Sci. 2012 Nov 7;279(1746):4342-51. Epub 2012 Aug 29.

Health equity: a lifecourse approach (104 Kb)

Maternal pelvic size not predictive of daughter's breast or ovarian cancer in a large Swedish cohort (160 Kb)

Social and biological determinants of reproductive success in Swedish males and females born 1915-29 (670 Kb)