Does childhood health affect chronic morbidity in later life?

Childhood Disadvantage and Health Problems in Middle and Later Life: Early Imprints on Physical Health?

Drawing from cumulative inequality theory, we examine the relationship between childhood disadvantage and health problems in adulthood. Using two waves of data from Midlife Development in the United States, we investigate whether childhood disadvantage is associated with adult disadvantage, including fewer social resources, and the effect of lifelong disadvantage on health problems measured at the baseline survey and a 10-year follow-up. Findings reveal that childhood socioeconomic disadvantage and frequent abuse by parents are generally associated with fewer adult social resources and more lifestyle risks. Health problems, in turn, are affected by childhood disadvantage and by lifestyle risks, especially smoking and obesity. Not only was early disadvantage related to health problems at the baseline survey, but childhood socioeconomic disadvantage and frequent abuse also were related to the development of new health problems at the follow-up survey. These findings reveal the imprint of early disadvantage on health decades later and suggest greater attention to resources, even during midlife, can interrupt the chain of risks.

Socioeconomic position in childhood and cancer in adulthood: a rapid-review

Background

The relationship of childhood socioeconomic position (SEP) to adult cancer has been inconsistent in the literature and there has been no review summarising the current evidence focused solely on cancer outcomes.

Methods and results

We performed a rapid review of the literature, which identified 22 publications from 13 studies, primarily in the UK and northern European countries that specifically analysed individual measures of SEP in childhood and cancer outcomes in adulthood. Most of these studies adjusted for adult SEP as a critical mediator of the relationship of interest.

Conclusions

Results confirm that childhood socioeconomic circumstances have a strong influence on stomach cancer and are likely to contribute, along with adult circumstances, to lung cancer through cumulative exposure to smoking. There was also some evidence of increased risk of colorectal, liver, cervical and pancreatic cancers with lower childhood SEP in large studies, but small numbers of cancer deaths made these estimates imprecise. Gaps in knowledge and potential policy implications are presented.

Educational Inequalities in the Transition to Adulthood in Belgium: The Impact of Intergenerational Mobility on Young-Adult Mortality in 2001-2009

Several studies have focused on the association between parental and personal socioeconomic position (SEP) and health, with mixed results depending on the specific health outcome, research methodology and population under study. In the last decades, a growing interest is given to the influence of intergenerational mobility on several health outcomes at young ages. This study addresses the following research question: Is educational intergenerational mobility associated with all-cause and cause-specific mortality in young adulthood? To this end, the Belgian 1991 and 2001 censuses are used, providing characteristics of young persons at two time points (T1 = 01/03/91;T2 = 01/10/01) and follow-up information on mortality and emigration between T2 and 31/12/09 (T3). The study population consists of all official inhabitants of Flanders and the Brussels-Capital Region at T2, born between 1972 and 1982 and alive at T2. Parental and personal education are divided into primary (PE), lower secondary (LSE), higher secondary (HSE) and higher education (HE). We analyse mortality between T2 and T3 calculating age-standardised mortality rates (ASMRs) and using Cox regression (hazard ratios = HR). Personal rather than parental education determines the observed mortality rates, with high all-cause mortality rates among those with PE, irrespective of parental education (e.g., among men ASMR_PE-PE = 200.0 [95% CI 158.0–241.9]; ASMR_HE-PE = 319.7 [183.2–456.3]) and low all-cause mortality among those in higher education, regardless of parental education (ASMR_PE-HE = 41.7 [30.8–52.6]; ASMR_HE-HE = 38.0 [33.2–42.8]). There is some variation by gender and according to cause of death. This study shows the strong association between personal education and young-adult mortality.

A Life Course Approach to Inequality: Examining Racial/Ethnic Differences in the Relationship between Early Life Socioeconomic Conditions and Adult Health Among Men

OBJECTIVE

Previous research has documented a relationship between childhood socioeconomic conditions and adult health, but less is known about racial/ethnic differences in this relationship, particularly among men. This study utilizes a life course approach to investigate racial/ethnic differences in the relationships among early and later life socioeconomic circumstances and health in adulthood among men.

DESIGN

Panel data from the Health and Retirement Study and growth curve models are used to examine group differences in the relationships among childhood and adult socioeconomic factors and age-trajectories of self-rated health among White, Black and Mexican American men aged 51-77 years (N=4147).

RESULTS

Multiple measures of childhood socioeconomic status (SES) predict health in adulthood for White men, while significantly fewer measures of childhood SES predict health for Black and Mexican American men. Moreover, the health consequences of childhood SES diminish with age for Black and Mexican American men. The childhood SES-adult health relationship is largely explained by measures of adult SES for White men.

CONCLUSIONS

The life course pathways linking childhood SES and adult health differ by race/ethnicity among men. Similar to arguments that the universality of the adult SES-health relationship should not be assumed, results from our study suggest that scholars should not assume that the significance and nature of the association between childhood SES and health in adulthood is similar across race/ethnicity among men.

The impacts of health insurance coverage on access to healthcare in children entering kindergarten

To examine access to healthcare and health outcomes for kindergartners as they relate to insurance status and type. For the 2008, 2009, and 2010 school years, surveys were distributed to parents with a child entering kindergarten in the state of Nevada. Surveys asked parents to provide information about their child concerning their insurance status, routine medical care, medical conditions, and health behaviors. Compared to their insured peers, uninsured kindergartners were less likely to have had a check-up in the previous 12 months (p < .001; OR 6.14; 95 % CI 5.77-6.53), have a primary physician (p < .001; OR 14.32; 95 % CI 13.49-15.20), or have seen a dentist (p < .001; OR 3.93; 95 % CI 3.70-4.16), and were more likely to have a reported unmet medical need (p < .001; OR 2.60; 95 % CI 2.19-3.07). Additionally, compared to children with private insurance, those children with public insurance were less likely to have had a check-up (p < .001; OR 1.73; 95 % CI 1.59-1.89), have a primary care provider (p < .001; OR 3.87; 95 % CI 3.55-4.21), and were more likely to have unmet medical needs (p < .001; OR 2.27; 95 % CI 1.83-2.81). For children in early development-a deeply critical period-insurance status and type are predictors of important access to healthcare variables.

Childhood Conditions and Multimorbidity Among Older Adults

OBJECTIVES

This research tests whether childhood conditions are associated with trajectories of chronic conditions among older adults.

METHODS

Using data from the Health and Retirement Study (1992-2008), a series of hierarchical linear models are used to estimate number of chronic conditions at survey midpoint and the rate of increase in chronic conditions across 18 years of data.

RESULTS

Results suggest that lower childhood socioeconomic status (SES) and poor childhood health are associated with increased number of chronic conditions; however, childhood SES is no longer associated with chronic conditions after adjustment for adult SES and adult health. Poor childhood health continues to be associated with total number of chronic conditions after adjustment for adult SES and health. Rate of change in chronic conditions was not associated with childhood conditions. Results from a multinomial logistic regression model further indicated that the association between childhood conditions and adult multimorbidity increased at higher levels of multimorbidity.

DISCUSSION

This research adds to the evidence that early life conditions have a lasting influence on adult health, and that their influence may be independent of adult health and SES.

Childhood Adversities and Adult Cardiometabolic Health: Does the Quantity, Timing, and Type of Adversity Matter?

OBJECTIVE

Adverse events in childhood can indelibly influence adult health. While evidence for this association has mounted, a fundamental set of questions about how to operationalize adverse events has been understudied.

METHOD

We used data from the National Survey of Midlife Development in the United States to examine how quantity, timing, and types of adverse events in childhood are associated with adult cardiometabolic health.

RESULTS

The best-fitting specification of quantity of events was a linear measure reflecting a dose-response relationship. Timing of event mattered less than repeated exposure to events. Regarding the type of event, academic interruptions and sexual/physical abuse were most important. Adverse childhood events elevated the risk of diabetes and obesity similarly for men and women but had a greater impact on women's risk of heart disease.

DISCUSSION

Findings demonstrate the insights that can be gleaned about the early-life origins of adult health by examining operationalization of childhood exposures.

Why do older people change their ratings of childhood health?

A growing number of studies in life course epidemiology and biodemography make use of a retrospective question tapping self-rated childhood health to assess overall physical health status. Analyzing repeated measures of self-rated childhood health from the Health and Retirement Study (HRS), this study examines several possible explanations for why respondents might change their ratings of childhood health. Results reveal that nearly one-half of the sample revised their rating of childhood health during the 10-year observation period. Whites and relatively advantaged older adults-those with more socioeconomic resources and better memory-were less likely to revise their rating of childhood health, while those who experienced multiple childhood health problems were more likely to revise their childhood health rating, either positively or negatively. Changes in current self-rated health and several incident physical health problems were also related to the revision of one's rating of childhood health, while the development of psychological disorders was associated with more negative revised ratings. We then illustrate the impact that these changes may have on an adult outcomes: namely, depressive symptoms. Whereas adult ratings of childhood health are likely to change over time, we recommend their use only if adjusting for factors associated with these changes, such as memory, psychological disorder, adult self-rated health, and socioeconomic resources.

Racial/ethnic disparities in midlife depressive symptoms: The role of cumulative disadvantage across the life course

This study examines the role of cumulative disadvantage mechanisms across the life course in the production of racial and ethnic disparities in depressive symptoms at midlife, including the early life exposure to health risk factors, the persistent exposure to health risk factors, and varying mental health returns to health risk factors across racial and ethnic groups. Using data from the over-40 health module of the National Longitudinal Study of Youth (NLSY) 1979 cohort, this study uses regression decomposition techniques to attend to differences in the composition of health risk factors across racial and ethnic groups, differences by race and ethnicity in the association between depressive symptoms and health risk factors, and how these differences combine within racial and ethnic groups to produce group-specific levels of--and disparities in--depressive symptoms at midlife. While the results vary depending on the groups being compared across race/ethnicity and gender, the study documents how racial and ethnic mental health disparities at midlife stem from life course processes of cumulative disadvantage through both unequal distribution and unequal associations across racial and ethnic groups.

Childhood and later life stressors and increased inflammatory gene expression at older ages

Adverse experiences in early life have the ability to "get under the skin" and affect future health. This study examined the relative influence of adversities during childhood and adulthood in accounting for individual differences in pro-inflammatory gene expression in late life. Using a pilot-sample from the Health and Retirement Study (N = 114) aged from 51 to 95, OLS regression models were run to determine the association between a composite score from three proinflammatory gene expression levels (PTGS2, ILIB, and IL8) and 1) childhood trauma, 2) childhood SES, 3) childhood health, 4) adult traumas, and 5) low SES in adulthood. Our results showed that only childhood trauma was found to be associated with increased inflammatory transcription in late life. Furthermore, examination of interaction effects showed that childhood trauma exacerbated the influence of low SES in adulthood on elevated levels of inflammatory gene expression-signifying that having low SES in adulthood was most damaging for persons who had experienced traumatic events during their childhood. Overall our study suggests that traumas experienced during childhood may alter the stress response, leading to more sensitive reactivity throughout the lifespan. As a result, individuals who experienced greater adversity in early life may be at higher risk of late life health outcomes, particularly if adulthood adversity related to SES persists.

Trends and group differences in the association between educational attainment and U.S. adult mortality: implications for understanding education's causal influence

Has the shape of the association between educational attainment and U.S. adult mortality changed in recent decades? If so, is it changing consistently across demographic groups? What can changes in the shape of the association tell us about the possible mechanisms in play for improving health and lowering mortality risk over the adult life course? This paper develops the argument that societal technological change may have had profound effects on the importance of educational attainment - particularly advanced education - in the U.S. adult population for garnering health advantages and that these changes should be reflected in changes in the functional form of the association between educational attainment and mortality. We review the historical evidence on the changing functional form of the association, drawing on studies based in the United States, to assess whether these changes are consistent with our argument about the role of technological change. We also provide an updated analysis of these functional form patterns and trends, contrasting data from the early 21st Century with data from the late 20th Century. This updated evidence suggests that the shape of the association between educational attainment and U.S. adult mortality appears to be reflecting lower and lower adult mortality for very highly educated Americans compared to their low-educated counterparts in the 21st Century. We draw on this review and updated evidence to reflect on the question whether education's association with adult mortality has become increasingly causal in recent decades, why, and the potential research, policy, and global implications of these changes.

Comparing early years and childhood experiences and outcomes in Scotland, England and three city-regions: a plausible explanation for Scottish 'excess' mortality?

BACKGROUND

Negative early years and childhood experiences (EYCE), including socio-economic circumstances, parental health and parenting style, are associated with poor health outcomes both in childhood and adulthood. It has also been proposed that EYCE were historically worse in Scottish areas, especially Glasgow and the Clyde Valley, compared to elsewhere in the UK and that this variation can provide a partial explanation for the excess of ill health and mortality observed among those Scottish populations.

METHODS

Multiple logistic regression analysis was applied to two large, representative, British birth cohorts (the NCDS58 and the BCS70), to test the independent association of area of residence at ages 7 and 5 with risk of behavioural problems, respiratory problems and reading/vocabulary problems at the same age. Cohort members resident in Scotland were compared with those who were resident in England, while those resident in Glasgow and the Clyde Valley were compared with those resident in Merseyside and Greater Manchester.

RESULTS

After adjustment for a range of relevant variables, the risk of adverse childhood outcomes was found to be either no different, or lower, in the Scottish areas. At a national level, the study reinforces the combined association of socio-economic circumstances, parental health (especially maternal mental health) and parenting with child health outcomes.

CONCLUSION

Based on these samples, the study does not support the hypothesis that EYCE were worse in Scotland and Glasgow and the Clyde Valley. It seems, therefore (based on these data), less likely that the roots of the excess mortality observed in the Scottish areas can be explained by these factors.

Cumulative childhood adversity, educational attainment, and active life expectancy among U.S. adults

Studies of the early-life origins of adult physical functioning and mortality have found that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies have generally assessed functioning and mortality as distinct processes and used cross-sectional prevalence estimates that neglect the interplay of disability incidence, recovery, and mortality. Here, we examine whether early-life disadvantages both shorten lives and increase the number and fraction of years lived with functional impairment. We also examine the degree to which educational attainment mediates and moderates the health consequences of early-life disadvantages. Using the 1998-2008 Health and Retirement Study, we examine these questions for non-Hispanic whites and blacks aged 50-100 years using multistate life tables. Within levels of educational attainment, adults from disadvantaged childhoods lived fewer total and active years, and spent a greater portion of life impaired compared with adults from advantaged childhoods. Higher levels of education did not ameliorate the health consequences of disadvantaged childhoods. However, because education had a larger impact on health than did childhood socioeconomic context, adults from disadvantaged childhoods who achieved high education levels often had total and active life expectancies that were similar to or better than those of adults from advantaged childhoods who achieved low education levels.

Migrant youth's emerging dietary patterns in Haiti: the role of peer social engagement

OBJECTIVE

The present study examines whether rural-to-urban migrant youth consume a greater diversity of high-sugar beverages and fried snacks (HSBFS) compared with their peers who remain in rural areas. It also tests whether the association between migration and HSBFS diversity is moderated by migrant youth's social engagement with their peers.

DESIGN

Participants were recruited in August and September 2011 following the completion of primary school (6th grade) and shortly before many rural youth migrate to urban areas. Participants were re-interviewed six months later. HSBFS diversity was assessed at follow-up; analyses control for baseline and follow-up characteristics.

SETTING

Baseline interviews occurred in rural Southeast Haiti. Follow-up interviews of migrants occurred at urban destinations in Haiti.

SUBJECTS

The sample includes 215 youth (mean age 15.9 years; 43.3 % female; 21.9 % rural-to-urban migrants) who were interviewed at baseline and follow-up.

RESULTS

Rural-to-urban migrant youth consumed a greater diversity of HSBFS products at follow-up than their rural counterparts (b=0.70, P≤0.05). Moreover, we found that this relationship varied by level of peer social engagement. Youth who migrated and had a high degree of peer social engagement consumed 2.2 additional types of HSBFS products daily than their counterparts who remained in rural areas and had low peer social engagement.

CONCLUSIONS

Higher HSBFS diversity among migrant youth is consistent with the patterns proposed by the nutrition transition. Interactions with peers may have an important influence as migrant youth adopt new dietary preferences. Emerging dietary patterns among youth migrants have important implications for health trajectories and the development of degenerative diseases.

Conditional health-related benefits of higher education: an assessment of compensatory versus accumulative mechanisms

A college degree is associated with a range of health-related benefits, but the effects of higher education are known to vary across different population subgroups. Competing theories have been proposed for whether people from more or less advantaged backgrounds or circumstances will gain greater health-related benefits from a college degree. This study draws on data from the National Longitudinal Study of Adolescent Health (Add Health) and recently developed models for analyzing heterogeneous treatment effects to examine how the effect of obtaining a college degree on the self-rated health of young adults varies across the likelihood of obtaining a college degree, a summary measure of advantage/disadvantage. Results indicate that a college degree has a greater effect on self-rated health for people from advantaged backgrounds. This finding differs from two recent studies, and possible reasons for the contrasting findings are discussed.

Determinants of tooth loss and chewing ability in mid- and late life in three Swedish birth cohorts

The aim of the research presented is to determine the influence of socio-economic factors in childhood and mid-life on multiple tooth loss and chewing problems in mid- and late life in three Swedish birth cohorts (1903–1910, 1911–1920 and 1921–1925). Longitudinal national Swedish surveys were used for the analysis. Participants were interviewed in mid-life in 1968 and later in life (77–99 years of age) in 2002. Childhood socio-economic positions (SEP) did not result in different odds of multiple tooth loss and chewing problems in mid- and late life, but persons with higher mid-life SEP had lower odds. Persons born into the 1921–1925 birth cohort had significantly lower odds of multiple tooth loss in late life than the 1903–1910 birth cohort. Women had higher odds of losing multiple teeth than men in late life but not mid-life. Neither gender nor childhood and mid-life SEP predicted chewing problems late in life, but older people with multiple tooth loss had higher odds of chewing difficulty than those with mainly natural teeth. Childhood conditions may contribute to multiple tooth loss in mid-life, which subsequently contributes to multiple tooth loss in late life. Tooth loss in late life is strongly associated with difficulty chewing hard food. Prevalence of multiple tooth loss is higher in women than in men in late life but not in mid-life.

The "long arm" of childhood health: linking childhood disability to late midlife mental health

A growing body of research underscores the early origins of health in later life; however, relatively little is known about the relationship between childhood physical health and adult mental health. This research explores the relationship between childhood disability and depressive symptoms among a nationally representative sample of late midlife adults (N = 3,572). Using data from Waves 8-10 (2006-2010) of the Health and Retirement Study, a series of ordinary least squares regression models were created to assess the number of depressive symptoms. Childhood disability was significantly associated with higher levels of depressive symptoms; however, late midlife social and health factors accounted for differences between those with and without childhood disability. Late midlife physical health appeared to be a particularly salient mediator. Individuals who experience childhood disability may accumulate more physical impairment over the life course, thus experiencing worse mental health such as greater depressive symptoms in late midlife.

Survival of offspring who experience early parental death: early life conditions and later-life mortality

We examine the influences of a set of early life conditions (ELCs) on all-cause and cause-specific mortality among elderly individuals, with special attention to one of the most dramatic early events in a child's, adolescent's, or even young adult's life, the death of a parent. The foremost question is, once controlling for prevailing (and potentially confounding) conditions early in life (family history of longevity, paternal characteristics (SES, age at time of birth, sibship size, and religious affiliation)), is a parental death associated with enduring mortality risks after age 65? The years following parental death may initiate new circumstances through which the adverse effects of paternal death operate. Here we consider the offspring's marital status (whether married; whether and when widowed), adult socioeconomic status, fertility, and later life health status. Adult health status is based on the Charlson Co-Morbidity Index, a construct that summarizes nearly all serious illnesses afflicting older individuals that relies on Medicare data. The data are based on linkages between the Utah Population Database and Medicare claims that hold medical diagnoses data. We show that offspring whose parents died when they were children, but especially when they were adolescents/young adults, have modest but significant mortality risks after age 65. What are striking are the weak mediating influences of later-life comorbidities, marital status, fertility and adult socioeconomic status since controls for these do little to alter the overall association. No beneficial effects of the surviving parent's remarriage were detected. Overall, we show the persistence of the effects of early life loss on later-life mortality and indicate the difficulties in addressing challenges at young ages.

Associations between race, lifecourse socioeconomic position and prevalence of diabetes among US women and men: results from a population-based panel study

BACKGROUND

Few studies have examined the degree to which racial disparities in the development of diabetes are accounted by differences in lifecourse socioeconomic position (SEP). We assessed the association between race, lifecourse SEP measures and prevalence of diabetes in a representative US sample of black and white adults.

METHODS

A generalised estimating equations approach was used with a sample of 3497 adults from the Americans' Changing Lives study. Sex-specific models were calculated to compute prevalence ratios (PR) for associations of race and SEP with self-reported diagnoses of diabetes.

RESULTS

For men, childhood and adult SEP were unrelated to diabetes, and adjustment for lifecourse SEP had little effect on the excess diabetes in blacks (PR=1.56, 95% CI 1.11 to 2.21). Adjustment for measures of lifecourse SEP reduced the PR for the association between race and diabetes in women from 1.96 (95% CI 1.52 to 2.54) to 1.40 (95% CI 1.04 to 1.87) with the respondent's education responsible for most of the reduction in the association. However, diabetes was also inversely associated with father's education, and low SEP throughout the lifecourse was associated with a nearly threefold increase in diabetes (PR=2.89, 95% CI 2.10 to 3.99).

CONCLUSIONS

Racial disparities in diabetes existed among both men and women, but lifecourse SEP was related to diabetes only among women. The pathway and cumulative hypotheses for lifecourse SEP effects on diabetes may be especially salient for women.

The interaction of family background and personal education on depressive symptoms in later life

This study assesses the interaction between personal education and family background during childhood on depressive symptoms in later life by applying Ross & Mirowsky's resource substitution and structural amplification theory of health and education. OLS regression models are estimated using data from the "Survey of Health, Ageing and Retirement in Europe" (SHARE), which covers information on current social and health status as well as retrospective life histories from 20,716 respondents aged 50 or older from thirteen European countries. Higher education helps to overcome the negative consequences of a poor family background. Since people from poor families are less likely to attain higher educational levels, they lack exactly the resource they need in order to overcome the negative consequences their non-prosperous background has on depressive symptoms. Thus, low family background and low personal education amplify each other. Examining the processes described by theory of resource substitution and structural amplification over different age groups from midlife to old-age suggests that the moderating effect of education remains constant over age among people coming from a poor family background. However, there is some evidence for a decrease with age in the buffering effect of a well-off family background on depressive symptoms among the low educated group. Furthermore, the educational gap in depression diverges with age among individuals originating from a well-off family background. Taken together the results cautiously allude to the conclusion that three processes - cumulative (dis-)advantage, age-as-leveler, and persistent inequalities - might take place.

Does childhood misfortune raise the risk of acute myocardial infarction in adulthood?

Whereas most research on acute myocardial infarction (AMI) has focused on more proximal influences, such as adult health behaviors, the present study examines the early origins of AMI. Longitudinal data were drawn from the National Survey of Midlife Development in the United States (N = 3032), a nationally representative survey of men and women aged 25-74, which spans from 1995 to 2005. A series of event history analyses modeling age of first AMI investigated the direct effects of accumulated and separate domains of childhood misfortune as well as the mediating effects of adult health lifestyle and psychosocial factors. Findings reveal that accumulated childhood misfortune and child maltreatment increased AMI risk, net of several adult covariates, including family history of AMI. Smoking fully mediated the effects of both accumulated childhood misfortune and child maltreatment. These findings reveal the importance of the early origins of AMI and health behaviors as mediating factors.

Independent associations of childhood and current socioeconomic status with risk of self-reported doctor-diagnosed arthritis in a family-medicine cohort of North-Carolinians

Background

Associations of socioeconomic status (SES) with the prevalence of various forms of arthritis are well documented. Increasing evidence suggests that SES during childhood is a lasting determinant of health, but its association with the onset of arthritis remains unclear.

Methods

Cross-sectional data on 1276 participants originated from 22 family practices in North-Carolina, USA. We created 4-level (high, medium, low, lowest) current SES and childhood SES summary scores based on parental and participant education, occupation and homeownership. We investigated associations of individual SES characteristics, summary scores and SES trajectories (e.g. high/low) with self-reported arthritis in logistic regression models progressively adjusted for race and gender, age, then BMI, and clustered by family practice.

Results

We found evidence for independent associations of both childhood and current SES with the reporting of arthritis across our models. In covariate-adjusted models simultaneously including current and childhood SES, compared with high SES participants in the lowest childhood SES category (OR = 1.39 [95% CI = 1.04, 1.85]) and those in the low (OR = 1.66 [95% CI = 1.14, 2.42]) and lowest (OR = 2.08 [95% CI = 1.16, 3.74]) categories of current SES had significantly greater odds of having self-reported arthritis.

Conclusions

Current SES and childhood SES are both associated with the odds of reporting arthritis within this primary-care population, although the possibly superseding influence of existing circumstances must be noted. BMI was a likely mechanism in the association of childhood SES with arthritis onset, and research is needed to elucidate further pathways linking the socioeconomic environment across life-stages and the development of rheumatic diseases.

Independent influences of current and childhood socioeconomic status on health outcomes in a North Carolina family practice sample of arthritis patients

OBJECTIVE

Compelling evidence suggests that socioeconomic status (SES) is a determinant of health outcomes among persons with arthritis. SES in early life has likewise been associated with various aspects of health, but the connection between childhood SES and health among people with arthritis remains to be investigated. The purpose of this study was to determine the influences of current and childhood SES on self-reported disability, depression, and physical and mental health among people with self-reported doctor-diagnosed arthritis.

METHODS

Data originated from a North Carolina network of primary care centers. Participants with self-reported arthritis with complete sociodemographic and relevant health information were retained in our sample (n = 782). We created summary measures for current and childhood SES from indicators of education, occupation, and homeownership, using parental SES as a proxy for participants' childhood SES. Linear regression models were used to assess the associations between health outcomes and SES variables separately and together, adjusting for key covariates.

RESULTS

Lower childhood and current SES scores were associated with worse disability and physical health. Current SES was furthermore associated with mental health and depressive symptoms. Associations of low current and childhood SES with health outcomes remained significant when concurrently included in a linear model.

CONCLUSION

Childhood and current SES are both determinants of health among persons with arthritis. This underscores the importance of childhood SES as a determinant of adult health among individuals with arthritis. Further studies should focus on these associations in different populations and across different types of arthritis.

Early Adult Obesity and U.S. Women's Lifetime Childbearing Experiences

Literature from multiple disciplines suggests that women who are obese during early adulthood may accumulate social and physiological impediments to childbearing across their reproductive lives. This led the authors to investigate whether obese young women have different lifetime childbearing experiences than leaner peers by analyzing data from 1,658 female participants in the 1979 National Longitudinal Survey of Youth. Study sample members were nulliparous women ages 20 - 25 in 1982. The authors examined their childbearing experiences between 1982 and 2006 and found that young women who were obese at baseline had higher odds of remaining childless and increased odds of underachieving fertility intentions than young women who were normal weight at baseline. These results suggest that obesity has long-term ramifications for women's childbearing experiences, with respect to whether and how many children women have in general and relative to the number of children they want.

Age trends in prevalence of cardiovascular risk factors in Roma minority population of Croatia

The Roma (Gypsy) are the largest European minority population characterized by poverty, social exclusion as well as by numerous life-style and cultural specificities, which all could have an adverse impact on their cardiovascular health. This study assesses the prevalence of cardiovascular diseases (CVD) risk factors in community-based sample of 430 adult Roma, living in rural area of Croatia, by providing the actual and age-adjusted estimates using the European standard population. The most prominent classical CVD risk phenotypes (blood pressure, obesity, smoking, glucose and lipid profile) were selected, and the standard risk cut-offs were applied. The study has shown that compared to general population of Croatia, the Roma population bears a high CVD risk factors load related to smoking and high glucose level. The CVD risk factors prevalence in Roma also showed important sex and age patterns, the most imposing of which are the findings of higher prevalence of CVD risks in women (especially obesity and triglyceride levels) and the trend of higher body mass index (BMI) level in younger age group (18-34 years) which both stand in contrast to the trends characterizing the general population of Croatia. These findings are complemented by the trend of decreased risk in the oldest age group (65+ years) for all investigated CVD risk factors (with exception of triglycerides level) compared to the 50-64 age group. We conclude that the age and sex CVD risks pattern point to the health transition of this rural Roma population. As we expect the proportion of CVD in the Roma minority of Croatia to increase in the future along with further modernization of their lifestyle, the CVD prevention measures in this population are urgent and should be primarily targeted at women and at the younger segment of this population.

Childhood infectious disease and premature death from cancer: a prospective cohort study

Studies of the association between early life infections and cancer have produced inconsistent findings, possibly due to limited adjustment for confounding and retrospective designs. This study utilised data from the Newcastle Thousand Families Study, a prospective cohort of 1,142 individuals born in Newcastle-upon-Tyne in 1947, to assess the impact of various childhood infectious diseases on cancer mortality during ages 15-60 years. Detailed information was collected prospectively on a number of early life factors. Deaths from cancer during ages 15-60 years were analysed in relation to childhood infections, adjusting for potential early-life confounders, using Cox proportional-hazards regression. In a subsample who returned questionnaires at aged 49-51 years, additional adjustment was made for adult factors to predict death from cancer during ages 50-60 years. Childhood history of measles and influenza, were both independently associated with lower cancer mortality during ages 15-60 years (adjusted hazard ratios = 0.39, 95% CI 0.17-0.88 and 0.49, 95% CI 0.24-0.98 respectively). In contrast, childhood pertussis was associated with higher cancer mortality during ages 15-60 years (adjusted hazard ratio = 4.88, 95% CI 2.29-10.38). In the subsample with additional adjustment for adult variables, measles and pertussis remained significantly associated with cancer mortality during ages 50-60 years. In this pre-vaccination cohort, childhood infection with measles and influenza were associated with a reduced risk of death from cancer in adulthood, while pertussis was associated with an increased risk. While these results suggest some disease-specific associations between early-life infections and cancer, further studies are required to confirm the specific associations identified.

Childhood misfortune and adult health: enduring and cascadic effects on somatic and psychological symptoms?

OBJECTIVE

This article traces the influence of early misfortune on somatic and psychological symptoms, examining whether the health disadvantages endure and/or worsen over a decade.

METHOD

The study uses two waves of data from the Midlife Development in the United States study. Structural equation models are used to assess change in somatic and psychological symptoms.

RESULTS

Findings reveal that childhood abuse is associated with more initial somatic and psychological symptoms among American adults, but that family structure and financial strain had little association with baseline adult symptoms. The effects of abuse were not observed at Wave 2 (W2), net of Wave 1 (W1) symptoms.

DISCUSSION

The results suggest an enduring-but not cascadic-effect of childhood abuse on adult health. There was little evidence that the consequences of early misfortune waned over the course of time or were less substantial for older adults; but neither did these early life experiences contribute to worsened symptoms over a decade of observation.

Body mass index, height and risk of lymphoid neoplasms in a large United States cohort

Results from epidemiologic studies examining associations between body size and risk of non-Hodgkin lymphoma (NHL) are inconsistent, and etiology may vary by histologic subtype of disease. Using Cox proportional hazards regression, multivariable relative risks (RRs) and 95% confidence intervals (CIs) were computed for associations of body mass index (BMI) and height with NHL in the prospective American Cancer Society Cancer Prevention Study-II Nutrition Cohort. From 1992 to 2007, 2074 incident cases of NHL were identified among 152 423 men and women. Obese individuals (BMI ≥ 30 kg/m(2)) had 23% higher incidence of NHL (95% CI 1.08-1.40) compared to those with normal weight (BMI 18.5-< 25 kg/m(2)). Height was positively associated with NHL (RR = 1.25, 95% CI 1.10-1.43, sex-specific quintile 5 vs. 1). BMI associations were strongest for diffuse large B-cell lymphoma. Height was most strongly associated with chronic lymphocytic leukemia/small lymphocytic lymphoma and to a lesser extent with multiple myeloma. These findings provide further evidence that body size may play a role in the etiology of NHL, which is of public health importance given the rapid rise in obesity worldwide.

Early life trauma predicts self-reported levels of depressive and anxiety symptoms in nonclinical community adults: relative contributions of early life stressor types and adult trauma exposure

Exposure to early life trauma is a known risk factor for depression and anxiety disorders in adulthood. This study aimed to evaluate the relative contributions of early life versus adult trauma in predicting levels of depressive and anxiety symptoms in nonclinical community adults. 1209 nonclinical community adults (18-70 years; 45% male) were assessed for mental health status, early life stressors, lifetime trauma exposure, and self-reported levels of depressive and anxiety symptoms. A subset of the full sample subjected to group comparisons (n = 1088) indicated that early life stressor exposure primarily accounted for significantly higher depressive and anxiety symptom scores when compared against adults reporting to be free of childhood stressor or adult trauma exposure. Subsequent hierarchical multiple regression analyses of this subset using five distinct early life stressor types, namely 'Interpersonal violation', 'Family breakup', 'Disasters/war', 'Familial health trauma/death' and 'Personal health trauma' derived from principal component analysis of a wide range of self-reported early stressor events in the full sample, showed childhood 'Interpersonal violation' differentially predicted higher self-reported depressive and anxiety symptom scores in both males and females. Adult trauma exposure did not significantly predict these symptom scores. These findings underline the relative importance of exposure to 'interpersonal violation' relative to other types of early life stressors and adult trauma in the risk of depressive and anxiety symptoms in nonclinical community adults.

Developmental Origins of Disease and Health Disparities: Limitations and Future Directions

The developmental origins of disease (DOD) model seeks to replace the traditional epidemiologic risk factor model with a perspective focused on the long-term consequences of nutritional resource scarcity during early life and the developmental trade-offs it creates. Research into the developmental origins of adult chronic disease has progressed substantially in recent years. However, a number of critical issues remain unexplored and under-developed. This chapter discusses some of those issues while providing an interdisciplinary population health perspective on the future of DOD research, with particular attention paid to health disparities and changes that are needed in health policy and intervention. I argue for research to provide greater specificity of the exposures of interest, a more comprehensive understanding of critical periods, and better theoretical and empirical integration of the developmental origins perspective within the life course and across multiple intergenerational processes.

Infant and fetal mortality among a high fertility and mortality population in the Bolivian Amazon

Indigenous populations experience higher rates of poverty, disease and mortality than non-indigenous populations. To gauge current and future risks among Tsimane Amerindians of Bolivia, I assess mortality rates and growth early in life, and changes in risks due to modernization, based on demographic interviews conducted Sept. 2002-July 2005. Tsimane have high fertility (total fertility rate = 9) and infant mortality (13%). Infections are the leading cause of infant death (55%). Infant mortality is greatest among women who are young, monolingual, space births close together, and live far from town. Infant mortality declined during the period 1990-2002, and a higher rate of reported miscarriages occurred during the 1950-1989 period. Infant deaths are more frequent among those born in the wet season. Infant stunting, underweight and wasting are common (34%, 15% and 12%, respectively) and greatest for low-weight mothers and high parity infants. Regression analysis of infant growth shows minimal regional differences in anthropometrics but greater stunting and underweight during the first two years of life. Males are more likely to be underweight, wasted, and spontaneously aborted. Whereas morbidity and stunting are prevalent in infancy, greater food availability later in life has not yet resulted in chronic diseases (e.g. hypertension, atherosclerosis and diabetes) in adulthood due to the relatively traditional Tsimane lifestyle.

Mind the gap: gender differences in child special health care needs

The gendered nature of special health care needs in childhood is an important yet understudied area. Although gendered differences in the prevalence of special health care needs have been documented, there is less knowledge about the factors which contribute to those differences. Two research questions guide this inquiry. First, is the gender gap consistent across child special health care need indicators? Second, to what extent is the gender gap in special health care needs driven by behavioral conditions? We use multiple indicators from the U.S. National Survey of Children's Health to expand our understanding about the dynamic relationship between gender and childhood health. There are clear gender differences in the prevalence of special health care needs. Boys are more likely than girls to have special health care needs overall and on the five separate components examined (medication, more care than typical, limitations, special therapies, and educational or behavioral problem). This gender gap is dynamic and varies by indicator; while behavioral conditions play a role, it remains even after controlling for behavioral conditions. The reasons for the gender differences appear to be both biological and social but much remains unknown about this pattern.

Educational Differences in U.S. Adult Mortality: A Cohort Perspective

We use hierarchical cross-classified random-effects models to simultaneously measure age, period, and cohort patterns of mortality risk between 1986 and 2006 for non-Hispanic white and non-Hispanic black men and women with less than a high school education, a high school education, and more than a high school education. We examine all-cause mortality risk and mortality risk from heart disease, lung cancer, and unpreventable cancers. Findings reveal that temporal reductions in black and white men's and women's mortality rates were driven entirely by cohort changes in mortality. Findings also demonstrate that disparate cohort effects between education groups widened the education gap in all-cause mortality risk and mortality risk from heart disease and lung cancer across this time period. Educational disparities in mortality risk from unpreventable cancers, however, did not change. This research uncovers widening educational differences in adult mortality and demonstrates that a cohort perspective provides valuable insights for understanding recent temporal changes in U.S. mortality risk.

Uncrossing the U.S black-white mortality crossover: the role of cohort forces in life course mortality risk

In this article, I examine the black-white crossover in U.S. adult all-cause mortality, emphasizing how cohort effects condition age-specific estimates of mortality risk. I employ hierarchical age-period-cohort methods on the National Health Interview Survey-Linked Mortality Files between 1986 and 2006 to show that the black-white mortality crossover can be uncrossed by factoring out period and cohort effects of mortality risk. That is, when controlling for variations in cohort and period patterns of U.S. adult mortality, the estimated age effects of non-Hispanic black and non-Hispanic white U.S. adult mortality risk do not cross at any age. This is the case for both men and women. Further, results show that nearly all the recent temporal change in U.S. adult mortality risk was cohort driven. The findings support the contention that the non-Hispanic black and non-Hispanic white U.S. adult populations experienced disparate cohort patterns of mortality risk and that these different experiences are driving the convergence and crossover of mortality risk at older ages.

Does childhood misfortune increase cancer risk in adulthood?

OBJECTIVE

To address the inconsistent findings on whether childhood misfortune increases adult cancer occurrence.

METHODS

This study uses longitudinal data from the National Survey of Midlife Development in the United States (MIDUS) that first sampled 3,032 respondents aged 25 to 74 during 1995-1996. A series of logistic regressions were estimated separately for men and women to test whether the effect of childhood misfortune on adult cancer was largely cumulative or specific to the type or profile of misfortune.

RESULTS

For men, additive childhood misfortune, physical abuse by father, and frequent abuse by either parent increased cancer risk. For women, physical abuse by mother and frequent abuse by either parent increased cancer risk.

DISCUSSION

Analyses revealed the importance of examining alternative specifications of childhood misfortune for men and women. Additive childhood misfortune predicted cancer for men only, whereas child abuse by parent of the same sex predicted cancer for men and women.

Integrating varieties of life course concepts

A body of work referred to as the "life course" framework (also known as "life course theory," the "life course paradigm," and the "life course perspective") has been increasingly used to motivate and justify the examination of the relationships among variables in social and behavioral science, particularly in the study of population health and aging. Yet, there is very little agreement on what some of these concepts mean, and there is hardly any agreement on what the "life course" is. This article focuses on the different ways in which the concept of "life course" is used in the contemporary study of aging and human development, particularly with regard to health and well-being. Clarification is given for how "life course" is distinguished from "life span" and "life cycle," among other "life" words. This work reviews the conceptual literature on the life course, beginning with its formative years in the 1960s and 1970s, through to the present time. Detailed research of several literatures across disciplines revealed five different uses of the term "life course": (a) life course as time or age, (b) life course as life stages, (c) life course as events, transitions, and trajectories, (d) life course as life-span human development, and (e) life course as early life influences (and their cumulation) on later adult outcomes. To the extent the concept of life course has a multiplicity of meanings that are at variance with one another, this is problematic, as communication is thereby hindered. On the other hand, to the extent the concept of life course involves a rich tapestry of different emphases, this is a good thing, and the diversity of meanings should be retained. This paper proposes a conceptual integration based in part on Riley's age stratification model that resolves the various meanings of life course into one general framework. Coupled with a demographic conceptualization of the life course, this framework embeds the concept of "life course" within a broader perspective of life-span development. This framework is proposed as an integrated perspective for studying the causes and consequences of "life course events and transitions" and understanding the manner by which "life events" and the role transitions they signify influence the life-span development of outcomes of interest across stages of the life cycle.

Health Inequalities, General Trends in Mortality and Morbidity, and Associated Factors

All measures of health status are ultimately derived from observations of individuals. At the field level we have such measures as self-assessed health status, report of a specific disease, record of a particular death, or an individual’s test on a biomarker, such as blood pressure or serum cholesterol. The observations for individuals are combined and summarized to represent subnational geographic areas, demographic or socioeconomic groups within countries, or national populations. The summary measures, whether they are percentages, averages, or rates, apply to groups. A problem arises when the measures that are based on groups are assumed to represent individuals. The analysis becomes especially problematic when the units analyzed are geographic areas and inferences are being made about individuals from the analysis for these geographic areas.

The impact of midlife educational, work, health, and family experiences on men's early retirement

OBJECTIVES

In empirical studies on predictors of retirement, midlife experiences have often remained implicit or been neglected. This study aims to improve our understanding of retirement by examining the impact of midlife educational, work, health, and family experiences on early retirement intentions and behavior. We distinguish theoretically and empirically between financial and nonfinancial preretirement factors through which midlife experiences could affect retirement.

METHODS

Using panel data of 1,229 Dutch male older workers, we estimated linear regression models to explain retirement intentions and logistic regression models to explain retirement behavior.

RESULTS

Midlife experiences in all studied life spheres are related to retirement intentions. Educational investments, job changes, late transitions into parenthood, and late divorces are associated with weaker intentions to retire early. Midlife health problems are related to stronger early retirement intentions. For midlife work and family experiences, the relationships are (partly) mediated by the preretirement financial opportunity structure. In the educational, work, and health spheres, the preretirement nonfinancial situation has a mediating effect. Only some of the predictors of retirement intentions also predicted retirement behavior.

DISCUSSION

Given the destandardization of life courses, information on distal life experiences might become even more important toward understanding retirement in the future.

Childhood health and labor market inequality over the life course

The authors use data from the Health and Retirement Study's Earnings Benefit File, which links Health and Retirement Study to Social Security Administration records, to estimate the impact of childhood health on earnings curves between the ages of 25 and 50 years. They also investigate the extent to which diminished educational attainment, earlier onset of chronic health conditions, and labor force participation mediate this relationship. Those who experience poor childhood health have substantially diminished labor market earnings over the work career. For men, earnings differentials grow larger over the early to middle career and then slow down and begin to converge as they near 50 years of age. For women, earnings differentials emerge later in the career and show no evidence of convergence. Part of the child health earnings differential is accounted for by selection into diminished educational attainment, the earlier onset of chronic disease in adulthood, and, particularly for men, labor force participation.

Emerging perspectives in social neuroscience and neuroeconomics of aging

This article introduces the special issue of 'Social Cognitive and Affective Neuroscience' on Aging Research, and offers a broad conceptual and methodological framework for considering advances in life course research in social neuroscience and neuroeconomics. The authors highlight key areas of inquiry where aging research is raising new insights about how to conceptualize and examine critical questions about the links between cognition, emotion and motivation in social and economic behavior, as well as challenges that need to be addressed when taking a life course perspective in these fields. They also point to several emerging approaches that hold the potential for addressing these challenges, through bridging approaches from laboratory and population-based science, bridging inquiry across life stages and expanding measurement of core psychological phenotypes.