Early Life Conditions and Later Life Mortality

Unequal before death: The effect of paternal education on children's old-age mortality in the United States

A growing body of research documents the relevance of parental education as a marker of family socio-economic status for children's later-life health outcomes. A strand of this literature evaluates how the early-life environment shapes mortality outcomes during infancy and childhood. However, the evidence on mortality during the life course and old age is limited. This paper contributes to the literature by analysing the association between paternal education and children's old-age mortality. We use data from Social Security Administration death records over the years 1988-2005 linked to the United States 1940 Census. Applying a family(cousin)- fixed-effects model to account for shared environment, childhood exposures, and common endowments that may confound the long-term links, we find that having a father with a college or high-school education, compared with elementary/no education, is associated with a 4.6- or 2.6-month-higher age at death, respectively, for the child, conditional on them surviving to age 47.

Early-Life Economic Conditions and Old-Age Male Mortality: Evidence from Historical County-Level Bank Deposit Data

This paper studies the long-run mortality effects of in-utero and early-life economic conditions. We examine how local economic conditions experienced during the Great Depression, proxied by county-level banking deposits during in-utero and first years of life, influence old-age longevity. We find that a one-standard-deviation rise in per capita bank deposits is associated with an approximately 1.7 month increase in males' longevity at old age. Additional analyses comparing state-level versus county-level economic measures provide insight on the importance of controlling for local-level confounders and exploiting more granular measures when exploring the relationship between early-life conditions and later-life mortality.

Long-Term Health Benefits of Occupational Licensing: Evidence from Midwifery Laws

During the late 19th and early 20th century, several states mandated midwifery licensing requirements to improve midwives' knowledge, education, and quality. Previous studies point to the health benefits of midwifery quality improvements for maternal and infant health outcomes. This paper exploits the staggered adoption of midwifery laws across states using event-study and difference-in-difference frameworks. We use the universe of death records in the US over the years 1979-2020 and find that exposure to a midwifery licensing law at birth is associated with a 2.5 percent reduction in cumulative mortality rates and an increase of 0.6 months in longevity during adulthood and old age. The effects are concentrated on deaths due to infectious diseases, neoplasm diseases, and suicide mortality. We also show that the impacts are confined among blacks and are slightly larger among males. Additional analyses using alternative data sources suggest small but significant increases in educational attainments, income, measures of socioeconomic status, employment, and measures of height as potential mechanism channels. We provide a discussion on the economic magnitude and policy implication of the results.

Advancing methods for the biodemography of aging within social contexts

Several social dimensions including social integration, status, early-life adversity, and their interactions across the life course can predict health, reproduction, and mortality in humans. Accordingly, the social environment plays a fundamental role in the emergence of phenotypes driving the evolution of aging. Recent work placing human social gradients on a biological continuum with other species provides a useful evolutionary context for aging questions, but there is still a need for a unified evolutionary framework linking health and aging within social contexts. Here, we summarize current challenges to understand the role of the social environment in human life courses. Next, we review recent advances in comparative biodemography and propose a biodemographic perspective to address socially driven health phenotype distributions and their evolutionary consequences using a nonhuman primate population. This new comparative approach uses evolutionary demography to address the joint dynamics of populations, social dimensions, phenotypes, and life history parameters. The long-term goal is to advance our understanding of the link between individual social environments, population-level outcomes, and the evolution of aging.

Offending and the Long-Term Risk of Death: An Examination of Mid-Life Mortality Among an Urban Black American Cohort

Research on the long-term relationship between offending and mortality is limited, especially among minorities who have higher risk of premature mortality and criminal offending, particularly arrest. Using Cox proportional hazard models, we estimate the relationship between young adult offending and later mortality (to age 58) among a community cohort of Black Americans (n = 1,182). After controlling for a wide range of covariates, results indicate that violent offenders are at heightened risk of mortality from young adulthood through midlife compared with both non-violent only offenders and non-offenders. Further analysis shows that this result is driven by the frequent, largely non-violent, arrests incurred among violent offenders. Criminal justice reform and collaboration with public health practitioners might be fruitful avenues to reduce mortality disparities.

Education mediating the associations between early life factors and frailty: a cross-sectional study of the UK Biobank

OBJECTIVES

Exposures in utero and during infancy may impact the development of diseases later in life. They may be linked with development of frailty, although the mechanism is unclear. This study aims to determine the associations between early life risk factors and development of frailty among middle-aged and older adults as well as potential pathways via education, for any observed association.

DESIGN

A cross-sectional study.

SETTINGS

This study used data from UK Biobank, a large population-based cohort.

PARTICIPANTS

502 489 individuals aged 37-73 years were included in the analysis.

PRIMARY AND SECONDARY OUTCOME MEASURES

Early life factors in this study included being breast fed as a baby, maternal smoking, birth weight, the presence of perinatal diseases, birth month and birth place (in or outside the UK). We developed a frailty index comprising 49 deficits. We used generalised structural equation modelling to examine the associations between early life factors and development of frailty and whether any observed association was mediated via educational attainment.

RESULTS

A history of breast feeding and normal birth weight were associated with a lower frailty index while maternal smoking, the occurrence of perinatal diseases and birth month with a longer day length were associated with a higher frailty index. Educational level mediated the relationship between these early life factors and frailty index.

CONCLUSIONS

This study highlights that biological and social risk occurring at different stages of life are related to the variations in frailty index in later life and suggests opportunities for prevention across the life course.

The Long Arm of Childhood: Does It Vary According to Health Care System Quality?

Increasing evidence points to the salience of early life experiences in shaping health inequalities, but scant research has considered the role of institutional resources as buffers in this relationship. Health care systems in particular are an understudied yet important context for the generation of inequalities from childhood into adulthood. This research investigates associations between childhood disadvantage and adult morbidity and examines the role of health care system quality in this relationship. We also consider the role of adult socioeconomic status. We merge individual-level data on major disease (2014 European Social Survey) with nation-level health care indicators. Results across subjective and objective approaches to health care system quality are similar, indicating a reduced association between childhood socioeconomic status and adult disease in countries with higher quality health care. In total, our results reiterate the long-term influence of childhood disadvantage on health while suggesting health care's specific role as an institutional resource for ameliorating life course health inequalities.

"Si Mis Papas Estuvieran Aquí": Unaccompanied Youth Workers' Emergent Frame of Reference and Health in the United States

Relying on in-depth interviews and ethnographic data in Los Angeles, California, this study examines the health experiences of unaccompanied, undocumented Latin American-origin immigrant youth as they come of age as low-wage workers. Findings demonstrate that unaccompanied, undocumented youth undergo cumulative physical and mental health disadvantages in the United States's secondary labor market and during critical developmental life stages while lacking the parental monitoring and guidance to navigate them. Developing comparisons between their past and present living conditions and between themselves and other youth in Los Angeles-what I refer to as an emergent frame of reference-youth workers come to perceive family disruptions, and especially separation from their parents, as the most salient factor affecting their health. While some youth ultimately resign themselves to short-term attempts to assuage illness, injury, or distress through activities like substance abuse, others pursue community connections and support groups that can sustain them long term.

The Long Shadow: Early-Life Adversity and Later-Life Loneliness in the United States

OBJECTIVES

This study assesses how early-life adversity (ELA) is associated with later-life loneliness among those aged 55 and older in the United States. We consider multiple domains of ELA to understand domain-specific associations between ELA and later-life loneliness.

METHODS

Using data from the 2008 to 2016 rounds of Health and Retirement Study (n = 29,661 person-waves [weighted]), we evaluate whether and how different domains of ELA are associated with loneliness, and how their relationships are explained through adulthood conditions and are dependent on educational attainment.

RESULTS

Our analyses demonstrate significant and distinctive relationships between various domains of ELA and later-life loneliness. Whereas adulthood conditions largely explain positive associations between loneliness with some domains of ELA (socioeconomic disadvantages and chronic diseases), disruptive home environment, risky adolescent behaviors, and impairment during childhood are still related to a higher level of loneliness after controlling for adulthood conditions. We also find empirical evidence supporting educational differences in relationships between some ELA domains and later-life loneliness. Our results also show that the associations between ELA and later-life loneliness differ between subdimensions of loneliness (emotional vs. social loneliness).

DISCUSSION

This study underscores ELA as an important early-life risk factor contributing to later-life loneliness. Our findings suggest that policy interventions to reduce adverse childhood experiences may alleviate individuals' exposure to loneliness in later life.

Mortality Advantage Reversed: The Causes of Death Driving All-Cause Mortality Differentials Between Immigrants, the Descendants of Immigrants and Ancestral Natives in Sweden, 1997-2016

A small but growing body of studies have documented the alarming mortality situation of adult descendants of migrants in a number of European countries. Nearly all of them have focused on all-cause mortality to reveal these important health inequalities. This paper takes advantage of the Swedish population registers to study all-cause and cause-specific mortality among men and women aged 15-44 in Sweden from 1997 to 2016 to a level of granularity unparalleled elsewhere. It adopts a multi-generation, multi-origin and multi-cause-of-death approach. Using extended, competing-risks survival models, it aims to show (1) how the all-cause mortality of immigrants arriving as adults (the G1), immigrants arriving as children (the G1.5) and children of immigrants born in Sweden to at least one immigrant parent (the G2) differs versus ancestral Swedes and (2) what causes-of-deaths drive these differentials. For all-cause mortality, most G1 (not Finns or Sub-Saharan Africans) have a mortality advantage. This contrasts with a near systematic reversal in the mortality of the G1.5 and G2 (notably among men), which is driven by excess accident and injury, suicide, substance use and other external cause mortality. Given that external causes-of-death are preventable and avoidable, the findings raise questions about integration processes, the levels of inequality immigrant populations are exposed to in Sweden and ultimately, whether the legacy of immigration has been positive. Strengths of the study include the use of quality data and advanced methods, the granularity of the estimates, and the provision of evidence that highlights the precarious mortality situation of the seldom-studied G1.5.

Early life environments and cognition in adulthood: New evidence using a semiparametric approach and quantile regression

Theories and empirical evidence document the importance of early life environmental factors on later life cognition. A next question is how and in what dimension associations between early life environments and later life cognition vary. Using data from the UK Biobank in conjunction with time-place-specific infant mortality rates, we assessed heterogeneous and non-linear associations between early life conditions and later life cognition. We found that the association between the infant mortality rate and later life cognition increased once the UK achieved very low infant mortality rates, suggesting that additional decreases in infant mortality rates in an industrialized society continue to improve later life cognition. We also found that infant mortality rates have stronger effects at upper quantiles of the cognition distribution. This implies that adverse early life environments may have an important role for an early manifestation of cognitive aging.

Race Inequity in School Attendance Across the Jim Crow South and Its Implications for Black-White Disparities in Trajectories of Cognitive Function Among Older Adults

OBJECTIVES

Although education is a key determinant of cognitive function, its role in determining Black-White disparities in cognitive function is unclear. This may be due, in part, to data limitations that have made it difficult to account for systemic educational inequities in the Jim Crow South experienced by older cohorts, including differences in the number of days Black students attended school compared to their White counterparts or Black peers in better-funded southern states. We determine if accounting for differential rates of school attendance across race, years, and states in the Jim Crow South better illuminates Black-White disparities in trajectories of cognitive function.

METHODS

We linked historical state-level data on school attendance from the 1919/1920 to 1953/1954 Biennial Surveys of Education to the Health and Retirement Study, a nationally representative, longitudinal study of U.S. adults older than age 50. We restricted our sample to Black and White older adults who attended school in the Jim Crow South and began primary school in/after 1919/1920 and completed primary/secondary school by 1953/1954 (n = 4,343). We used linear mixed models to estimate trajectories of total cognitive function, episodic memory, and working memory.

RESULTS

Self-reported years of schooling explained 28%-33% of the Black-White disparity in level of cognitive function, episodic memory, and working memory. Duration of school, a measure that accounted for differential rates of school attendance, explained 41%-55% of the Black-White disparity in these outcomes.

DISCUSSION

Our study highlights the importance of using a more refined measure of schooling for understanding the education-cognitive health relationship.

Work-Family Reconciliation and Children's Well-Being Disparities across OECD Countries

Socioeconomic inequalities in health and well-being are large, beginning early in childhood and accumulating over the life course, but they also vary widely across rich developed nations. Despite this well-known cross-national variation, research has yet to examine why children's health disparities might be larger or smaller based on national policy contexts and macroeconomic conditions. Parental health and well-being suffer under high work-family or economic strain, which may directly impact children's health inequalities by family social class. These childhood health disadvantages, if not substantially improved, compound to even larger adult inequalities. To examine the role of national work-family reconciliation in children's health, we merge country-level policy data with 2006 and 2010 World Health Organization child-level data on mental and physical well-being and family economic disadvantage. Based on adjusted estimates, we find greatly narrowed disparities in children's self-rated health as work flexibility and vacation-sick leave mandates become more generous. However, cash transfer policies including family benefits spending and childcare costs were not associated with the size of children's health disparities. Taken together, our results suggest the distinctive value of better work-family accommodations, rather than any generic cash allowances, for lessening family-based inequalities in children's health and human capital development.

Developing Health Lifestyle Pathways and Social Inequalities across Early Childhood

Lifestyles are a long-theorized aspect of social inequalities that root individual behaviors in social group differences. Although the health lifestyle construct is an important advance for understanding social inequalities and health behaviors, research has not theorized or investigated the longitudinal development of health lifestyles from infancy through the transition to school. This study documented children's longitudinal health lifestyle pathways, articulated and tested a theoretical framework of health lifestyle development in early life, and assessed associations with kindergarten cognition, socioemotional behavior, and health. Latent class analyses identified health lifestyle pathways using the US Early Childhood Longitudinal Study - Birth Cohort (ECLS-B; N≈6,550). Children's health lifestyle pathways were complex, combining healthier and unhealthier behaviors and changing with age. Social background prior to birth was associated with health lifestyle pathways, as were parents' resources, health behaviors, and non-health-focused parenting. Developing health lifestyle pathways were related to kindergarten cognition, behavior, and health net of social background and other parent influences. Thus, family context is important for the development of complex health lifestyle pathways across early childhood, which have implications for school preparedness and thus for social inequalities and well-being throughout life. Developing health lifestyles both reflect and reproduce social inequalities across generations.

Geographic variation in Alzheimer's disease mortality

OBJECTIVE

Accumulating evidence suggests the possibility that early life exposures may contribute to risk of Alzheimer's Disease (AD). This paper explores geographic disparities in AD mortality based on both state of residence in older age as well as state of birth measures in order to assess the relative importance of these factors.

METHODS

We use a subset of a large survey, the NIH-AARP Diet and Health Study, of over 150,000 individuals aged 65-70 with 15 years of mortality follow-up, allowing us to study over 1050 cases of AD mortality. We use multi-level logistic regression, where individuals are nested within states of residence and/or states of birth, to assess the contributions of place to AD mortality variation.

RESULTS

We show that state of birth explains a modest amount of variation in AD mortality, approximately 4%, which is consistent with life course theories that suggest that early life conditions can produce old age health disparities. However, we also show that nearly all of the variation from state of birth is explained by state of residence in old age.

CONCLUSIONS

These results suggest that later life factors are potentially more consequential targets for intervention in reducing AD mortality and provide some evidence against the importance of macro-level environmental exposures at birth as a core determinant of later AD.

The Effects of Education on Mortality: Evidence From Linked U.S. Census and Administrative Mortality Data

Does education change people's lives in a way that delays mortality? Or is education primarily a proxy for unobserved endowments that promote longevity? Most scholars conclude that the former is true, but recent evidence based on Danish twin data calls this conclusion into question. Unfortunately, these potentially field-changing findings-that obtaining additional schooling has no independent effect on survival net of other hard-to-observe characteristics-have not yet been subject to replication outside Scandinavia. In this article, we produce the first U.S.-based estimates of the effects of education on mortality using a representative panel of male twin pairs drawn from linked complete-count census and death records. For comparison purposes, and to shed additional light on the roles that neighborhood, family, and genetic factors play in confounding associations between education and mortality, we also produce parallel estimates of the education-mortality relationship using data on (1) unrelated males who lived in different neighborhoods during childhood, (2) unrelated males who shared the same neighborhood growing up, and (3) non-twin siblings who shared the same family environment but whose genetic endowments vary to a greater degree. We find robust associations between education and mortality across all four samples, although estimates are modestly attenuated among twins and non-twin siblings. These findings-coupled with several robustness checks and sensitivity analyses-support a causal interpretation of the association between education and mortality for cohorts of boys born in the United States in the first part of the twentieth century.

Maternal Educational Attainment and Child Health in the United States

PURPOSE

To identify how child health status differs by mother's educational attainment for the overall US population and by race/ethnicity and to assess whether these disparities have changed from 2000 to 2017.

DESIGN

Repeated cross-sectional data from the 2000-2017 National Health Interview Survey (NHIS).

SETTING

United States.

PARTICIPANTS

Children aged 1 to 17 years from a nationally representative sample of the noninstitutionalized US population (N = 199 427).

MEASURES

Reported child health status, mother's educational attainment, child's race/ethnicity, and control variables were measured using the NHIS.

ANALYSIS

Using logistic regression models, we assessed the relationship between maternal education and child health. Missing data were imputed.

RESULTS

Children whose mothers had less than a high school education (odds ratio [OR] = 3.84, 95% confidence interval [CI]: 3.62-4.07), high school diploma or equivalent (OR = 2.57, 95% CI: 2.44-2.70), or some college (OR = 1.90, 95% CI: 1.80-2.00) had worse reported health status compared to children whose mothers graduated college. These associations were strongest among non-Hispanic white children, with significantly (P < .05) smaller associations observed for non-Hispanic black, Mexican origin, and other Hispanic children. The associations were smaller but persisted with inclusion of controls. From 2000 to 2017, child health disparities slightly narrowed or remained stagnant among white, non-Hispanic black, and other Hispanic children but widened for Mexican origin children (P < .05).

CONCLUSION

Maternal education disparities in child health are wide and have persisted.

Effects of early life factors on the health and quality of life of older adults

BACKGROUND

Few studies on the effects of early life factors on the health and quality of life of adults have been conducted in Turkey. We aimed to investigate the effects of early life factors on the health and quality of life of older adults.

METHODS

We administered a questionnaire to 350 adults, aged 50-89 years, living in Cankaya, Ankara. The questionnaire covered sociodemographic characteristics, early life characteristics, health status, and the World Health Organization Quality of Life-Ageing scale. Data were analyzed using χ ² tests, independent samples t-tests, one-way anova, and binary logistic regression analysis.

RESULTS

The analyses showed that the most important risk factors for chronic disease were being ≥65 years (odds ratio (OR) = 2.34), having a chronic health problem before 18 years of age (OR = 2.48), experiencing prolonged hospitalization or bed rest before 18 years of age (OR = 2.65), and experiencing parental unconcern during early life (OR = 2.13) (P < 0.05). In addition, having a high school education or less includes people who have primary or secondary or high school diploma (OR = 1.65), having lived in a village (OR = 1.65), having a low family economic status (OR = 2.40), and having experienced one negative event (OR = 1.41) or two or more negative events (OR = 1.39) during their early lives were identified as important risk factors for low quality of life (P < 0.05).

CONCLUSION

Early life factors are among the important determinants of the health and quality of life of older adults in Turkey.

Childhood Socioeconomic Status and Stress in Late Adulthood: A Longitudinal Approach to Measuring Allostatic Load

Objectives: This study examines how the effects of childhood socioeconomic status (SES) may carry on into late adulthood. Methods: We examine how childhood SES affects both perceived stress and allostatic load, which is a cumulative measure of the body’s biologic response to chronic stress. We use the National Social Life, Health, and Aging Project, Waves 1 and 2, and suggest a novel method of incorporating a longitudinal allostatic load measure. Results: Individuals who grew up in low SES households have higher allostatic load scores in late adulthood, and this association is mediated mostly by educational attainment. Discussion: The longitudinal allostatic load measure shows similar results to the singular measures and allows us to include 2 time points into one outcome measure. Incorporating 2 separate time points into one measure is important because allostatic load is a measure of cumulative physiological dysregulation, and longitudinal data provide a more comprehensive measure.

Children's Sense of Control as a Determinant of Adult Health: Causation, Mediation, and Spuriousness

Previous research suggests higher levels of education instill a greater sense of internal control that promotes health in adulthood. We propose that the sense of control has its origins in early childhood and that prior research has possibly misattributed a mediational role to sense of control in adulthood. Using a conceptual framework that includes these early influences, we employ data from the 1970 British Cohort Study ( N = 9,855), examining the extent to which the association between education and adult health is spurious due to these early childhood factors. We find that the internal sense of control as assessed in childhood and adolescence has profound influences on both education and health in early adulthood and that a substantial portion of the latter association is spurious. We conclude that the sense of control is an important health-related factor originating early in life, influencing both health and education later in adulthood.

Alcohol's Collateral Damage: Childhood Exposure to Problem Drinkers and Subsequent Adult Mortality Risk

The importance of childhood circumstances, broadly defined, for shaping adult health and longevity is well-established. But the significance of one of the most prevalent childhood adversities-exposure to problem drinkers-has been understudied from a sociological perspective and remains poorly understood. We address this gap by drawing on cumulative inequality theory, using data from the 1988-2011 National Health Interview Survey-Linked Mortality Files, and estimating Cox proportional hazards models to examine the relationship between exposure to problem drinkers in childhood and adult mortality risk. Childhood exposure to problem drinkers is common (nearly 1 in 5 individuals were exposed) and elevates adult overall and cause-specific mortality risk. Compared to individuals who had not lived with a problem drinker during childhood, those who had done so suffered 17 percent higher risk of death (p<.001) over the follow-up period, net of age, sex, and race/ethnicity. We find compelling evidence that the duration, source, and intensity of exposure to problem drinkers in childhood contributes to inequality in adult mortality risk. Favorable socioeconomic status in adulthood does not ameliorate the consequences of childhood exposure to problem drinkers. The primary intervening mechanisms are risky behaviors, including adult drinking and smoking. The findings-which reveal that the influence of problem drinking is far-reaching and long-term-should inform policies to improve childhood circumstances, reduce detrimental effects of problem drinking, and increase life expectancy.

Life-Course Socioeconomic Status and Metabolic Syndrome Among Midlife Women

OBJECTIVES

We examine whether women's risks of having metabolic syndrome (MetS) at pre/early-menopausal baseline, and of developing MetS after baseline, are associated with childhood and adult socioeconomic statuses (SESs); and whether the associations are mediated by adult reproductive, economic, behavioral, and psychosocial factors.

METHOD

Using data on white and black women collected prospectively for 12 years in the Study of Women's Health Across the Nation, we estimated odds of MetS at pre/early-menopausal baseline with logistic regression, and incidence of MetS after baseline with Cox proportional hazards models.

RESULTS

Women raised in "adverse" childhood SES had marginally greater odds of MetS at baseline than did women raised in "good" SES, and women with a high school credential or less had significantly greater odds than college-educated women, in mutually adjusted models. The elevated odds partly reflected SES-related differences in exercise and alcohol consumption. Incidence after baseline was associated with education, not childhood SES, and partly mediated by health behaviors. Differences in the probability of surviving without MetS between the most and least socioeconomically advantaged women nearly doubled between ages 50 and 60.

DISCUSSION

Childhood and adult SES predict women's risks of MetS as they approach the menopause transition; adult SES is primarily important afterwards.

Long-term trends in adult mortality for U.S. Blacks and Whites: an examination of period- and cohort-based changes

Black-white differences in U.S. adult mortality have narrowed over the past five decades, but whether this narrowing unfolded on a period or cohort basis is unclear. The distinction has important implications for understanding the socioeconomic, public health, lifestyle, and medical mechanisms responsible for this narrowing. We use data from 1959 to 2009 and age-period-cohort (APC) models to examine period- and cohort-based changes in adult mortality for U.S. blacks and whites. We do so for all-cause mortality among persons aged 15-74 as well as for several underlying causes of death more pertinent for specific age groups. We find clear patterns of cohort-based reductions in mortality for both black men and women and white men and women. Recent cohort-based reductions in heart disease, stroke, lung cancer, female breast cancer, and other cancer mortality have been substantial and, save for breast cancer, have been especially pronounced for blacks. Period-based changes have also occurred and are especially pronounced for some causes of death. Period-based reductions in blacks' and whites' heart disease and stroke mortality are particularly impressive, as are recent period-based reductions in young men's and women's mortality from infectious diseases and homicide. These recent period changes are more pronounced among blacks. The substantial cohort-based trends in chronic disease mortality and recent period-based reductions for some causes of death suggest a continuing slow closure of the black-white mortality gap. However, we also uncover troubling signs of recent cohort-based increases in heart disease mortality for both blacks and whites.

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.

Biological risk in the Mexican population at the turn of the 21st century

Mexico has experienced changes in its demographic and epidemiologic profile accompanied by recent changes in nutrition and income. Thus, the old and the young have experienced very different environments. Using data from the Mexican National Health Nutrition Survey 2006, we examine age and sex differences in physiological status and dysregulation and assess how socioeconomic factors associate with variability in biological indicators of health. Results indicate that young people have experienced better physical development as evidenced by their being taller and having less stunting. There is currently little under-nutrition in Mexico, but there is evidence of over-nutrition as indicated by high prevalence of overweight across the age range. Physiological dysregulation across multiple systems is higher in Mexicans than Americans across all ages. Mexicans have: higher levels of blood pressure, plasma glucose, and especially for women, dysregulated cholesterol and higher body weight. Low education is associated with both being stunted and overweight, and with adverse levels of HDL cholesterol and more physiological risk factors. Rural dwelling males are less likely to be overweight as are females living in poor states. Living in a poor state among females and having rural residence among males is associated with a higher number of high-risk factors. Overweight is a strong predictor of hypertension. Age differences in indicators of physiological development suggest that the epidemiological and demographic transitions in Mexico were accompanied by improved physical development; however, increases in nutrition may have reached a point of diminishing returns as Mexico switched from a state of under-nutrition to over-nutrition.

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.

Analysis of cribra orbitalia in the earliest inhabitants of medieval Vilnius

The purpose of this work is to present an analysis of cribra orbitalia (CO) from the population of a medieval cemetery in Vilnius, Lithuania, dated between the end of the 13th to the beginning of the 15th centuries. The sample consisted of 208 individuals with sufficiently preserved orbits: 82 subadults and 122 adults. CO was correlated with sex, age-at-death, and three skeletal indicators of biological health: linear enamel hypoplasia, periostitis, and adult femur length as a proxy value for stature. Siler's and Gompertz-Makeham's parametric models of mortality as well as χ2 statistics were used to evaluate these relationships. Almost one-third of all analyzed individuals had signs of CO, including approximately 60% of the subadults. There was a very strong relationship between the age-at-death and incidence of CO, i.e., individuals with the lesion were dying much younger. The frequency of CO among the sexes was not statistically significant. On the other hand, CO had a negative effect only on adult males, i.e., males who had the lesion died at a younger age. Furthermore, CO and linear enamel hypoplasia were positively related for subadults, whereas no significant relationships were found among adults of corresponding sex. Incidence of periostitis and adult stature were not related to CO.