Childhood Disadvantage and Adult Functional Status: Do Early-Life Exposures Jeopardize Healthy Aging?

Objectives To examine whether childhood disadvantage is associated with later-life functional status and identify mediating factors. Methods Unique and additive effects of five childhood domains on functional status were assessed at baseline (2006) and over time (2006–2016) in a sample of 13,894 adults from the Health and Retirement Study (>50 years). Adult health behaviors and socioeconomic status (SES) were tested as mediators. Results Respondents exposed to multiple childhood disadvantages (OR = .694) as well as low childhood SES (OR = .615), chronic diseases (OR = .694), impairments (OR = .599), and risky adolescent behaviors (OR = .608) were less likely to be free of functional disability by baseline. Over time, these unique and additive effects of childhood disadvantage increased the hazard odds of eventually developing functional disability (e.g., additive effect: hOR = 1.261). Adult health behaviors and SES mediated some of these effects. Discussion Given the enduring effects of childhood disadvantage, policies to promote healthy aging should reduce exposure to childhood disadvantage.

Associations between life course socioeconomic conditions and the Pace of Aging

Background Socioeconomic disadvantage is a well-established predictor of morbidity and mortality, and is thought to accelerate the aging process. This study examined associations between life course socioeconomic conditions and the Pace of Aging, a longitudinal measure of age-related physiological decline. Methods Data were drawn from a Swiss population-based cohort of individuals originally recruited between 2003 and 2006, and followed up for 11 years (2834 women, 2475 men aged 35 – 75 years (mean 52)). Pace of Aging was measured using three repeated assessments of 12 biomarkers reflecting multiple body systems. Analysis tested associations of socioeconomic conditions with physiological status at baseline and with the Pace of Aging. Results Participants with more life course socioeconomic disadvantage were physiologically older at baseline and experienced faster Pace of Aging. Effect-sizes (β) for associations of childhood socioeconomic disadvantage with baseline physiological status ranged from 0.1-0.2; for adulthood socioeconomic disadvantage, effect-sizes ranged from 0.2-0.3. Effect-sizes were smaller for associations with the Pace of Aging (< 0.05 for childhood disadvantage, 0.05-0.1 for adulthood disadvantage). Those who experienced disadvantaged socioeconomic conditions from childhood to adulthood aged 10% faster over the 11 years of follow-up as compared with those who experienced consistently advantaged socioeconomic conditions. Covariate adjustment for health behaviors attenuated associations, but most remained statistically significant. Conclusions Socioeconomic inequalities contribute to a faster Pace of Aging, partly through differences in health behaviors. Intervention to slow aging in at risk individuals is needed by midlife, before aetiology of aging-related diseases become established.

Childhood Disadvantage and Later-Life Multimorbidity: Demonstrating Robustness Under Imperfect Identification

This study assesses the relationship between indicators of early childhood disadvantage and later-life multimorbidity within a nationally representative sample of Brazilians aged 50 and over (n = 9,412). Data come from the baseline assessment (2015/2016) of the Brazilian Longitudinal Study of Aging (ELSI). We employed survey-weighted Ordinary Least Squares regression to estimate the effects of individual and combined measures of childhood disadvantage on the total number of chronic conditions in later life. Mediation analysis assessed whether adult socioeconomic status (SES) mediated the relationship between childhood disadvantage and chronic conditions. We found that individual and combined measures of childhood disadvantage were associated with the total number of chronic conditions, even after controlling for potential confounders. Mediation analysis suggested that part of the effect of childhood adversity is mediated by higher SES in adulthood (~10%). A formal strategy of sensitivity analysis showed that omitted variable bias is extremely unlikely. To rule out the observed effect, an unobserved hypothetical confounder would need the explanatory power of the residual variance of both the independent and the dependent variables that is at least 30 times larger than that of BMI or 5 times larger than the explanatory power of age. Results should inform efforts to strengthen interventions targeting early childhood development and to improve other key inputs (such as education) to enhance adult SES and lessen the impact of early life stressors on health in older adulthood.

Lasting effects of residential mobility during childhood on psychopathology among Chinese University students

Background Residential mobility during childhood increases risk of psychopathology in adulthood and is a common experience among Chinese children. This study investigated associations between number and age of first move, etiological risk factors for psychopathology, and common mental disorders in adolescence and early adulthood. Methods The sample included 39,531 undergraduates (84.5% completion rate) age 15–34 years in their first year at a Chinese comprehensive university in annual cross-sectional surveys during 2014–2018. Common mental disorders measured using standardised self-report instruments. Data analysed using logistic regression models and interaction analysis. Results Half of all students experienced one or more moves of residence before age 15 years. Outcomes of Depression, Somatisation, Obsessive-compulsive disorder, Hallucinations and Delusions, and Suicide attempts showed dose-response relationships with increasing number of moves. Other etiological risk factors, including childhood disadvantage and maltreatment, showed similar dose response relationships but did not confound associations with mobility. We found interactions between reporting any move and being a left-behind child on depression and somatisation; number of moves and younger age at first move on depression, somatisation, suicide attempts and hallucinations and delusions. Conclusions Residential mobility in childhood is associated with psychopathology in adulthood and this association increases with increasing number of moves. Mobility is also associated with childhood disadvantage and maltreatment but associations with psychopathology are independent of these factors. Multiplicative effects were shown for multiple moves starting at a younger age and if the participant had been a left-behind child.

The lasting imprint of childhood disadvantage: cumulative histories of exposure to childhood adversity and trajectories of psychological distress in adulthood

This study contributes to the literature on the long-term effects of childhood disadvantage on mental health by estimating the association between patterns of cumulative childhood adversity on trajectories of psychological distress in adulthood. There is little research that investigates how compositional variations in the accumulation of childhood adversity may initiate distinct processes of disadvantage and differentially shape trajectories of psychological distress across the adult life course. Using the Panel Study of Income Dynamics’ Childhood Retrospective Circumstance Study and latent class analysis, we first identify distinct classes representing varied histories of exposure to childhood adversities using 25 indicators of adversity across multiple childhood domains. Next, the latent classes are included as predictors of trajectories of psychological distress in adulthood. The results demonstrate that patterns of experiences of childhood adversity are associated with higher levels of adult psychological distress that persists, and in some cases worsens, in adulthood, contributing to disparities in mental health across the life course.<br /><br />Key messages<br /><ul><li>Cumulative adversity during childhood has an enduring influence on adult psychological distress.</li><br /><li>Childhood adversities of various types and severities tend to co-occur, which is important for measures of cumulative childhood adversity to consider.</li><br /><li>Childhood adversity increases adult psychological distress, contributing to disparities in mental health across the life course.</li></ul>

Explaining Cross-National Differences in Social Background Effects: What Have We Learned?

This chapter provides an overview of economic, cultural and institutional narratives capable of explaining cross-national variation in the consequences of childhood disadvantage for socio-demographic outcomes in adulthood. However, testing these explanations is often hard, given a series of methodological challenges. Next, the ways in which the Contexts of Opportunity Project has tackled these challenges and its key results are presented. Childhood disadvantage has pervasive consequences for demographic outcomes in young adulthood and socio-economic and well-being outcomes in later adulthood. Strong cross-national variation in the strength of these relationships is observed, though. Childhood disadvantage often seems to have weaker consequences in more individualized societies. The chapter concludes with a discussion of future challenges for demographic research on cross-national differences.

Social Background and Adult Socio-Demographic Outcomes in a Cross-National Comparative Perspective: An Introduction

An individual choice paradigm, focusing on individual preferences and values, has long dominated our understanding of socio-demographic outcomes. Recently, a trend towards an unequal choice paradigm, stressing how inequality in opportunities structures socio-demographic outcomes, is observed. This chapter outlines these changes and argues for a comparative perspective to examine how childhood disadvantage impacts these socio-demographic outcomes. The expectation is that the consequences of childhood disadvantage for demographic outcomes in young adulthood and for socio-economic and well-being outcomes in middle and late adulthood depend on the opportunities that national contexts offer to abate the adverse impact of economic and social deprivation. Subsequently, all chapters of the book are briefly introduced and their contribution to understanding this key issue is discussed.

Early Social Origins of Biological Risks for Men and Women in Later Life

We investigate whether childhood exposures influence adult chronic inflammation and mortality risk via adult health characteristics and socioeconomic status (SES) and whether gender moderates these relationships. Analyzing a longitudinal national sample of 9,310 men and women over age 50, we found that childhood SES, parental behaviors, and adolescent behaviors were associated with adult chronic inflammation via health characteristics and SES in adulthood. The process of disadvantage initiated by low childhood SES (i.e., adult health risk factors, socioeconomic disadvantage, and chronic inflammation) subsequently raised mortality risk. In addition, gender moderated the mediating influence of childhood SES via unhealthy behaviors and parental behaviors via adult SES. Demonstrating how social forces shape biological health through multiple mechanisms informs health policies by identifying multiple points of intervention in an effort to reduce the lasting consequences of childhood disadvantage.