The scars of the past? Childhood health and health differentials in later life

Distinct domains of childhood disadvantage and cognitive performance among older Brazilians: Evidence from ELSI-Brazil

Objective

To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country.

Methods

This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest.

Results

Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital.

Conclusions

We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.

The Relationship Between Childhood Circumstances and Late Life Physical and Mental Health: The Role of Adult Socioeconomic Status

OBJECTIVES

Socioeconomic status and health in childhood are linked to health outcomes in later life. Health outcomes may also be shaped by socioeconomic circumstances in adulthood and later life. This paper examined the relationship between childhood conditions and later life health and tested whether this relationship was mediated by later life economic living standards.

METHODS

Data from a longitudinal study of aging was combined with retrospective life history data from 787 participants from the New Zealand Health, Work and Retirement Study.

RESULTS

Significant relationships were found between childhood conditions and later life health. These relationships were mediated by economic living standards in older age, but the partial direct effect of childhood conditions on health found in early older age became fully meditated 10 years later.

CONCLUSION

While childhood circumstances are part of this complex relationship, socioeconomic conditions in later life are vital to ensuring ongoing health into older age.

Actor-Partner Effects of Childhood Disadvantage on Later Life Subjective Well-Being Among Individuals in Coresidential Unions

OBJECTIVES

Prior research on cumulative disadvantage has primarily focused on individuals' own childhood adversity for their later-life outcomes. Nevertheless, partner's childhood disadvantage may also shape respondent's later-life well-being.

METHODS

Drawing on a household-level dataset, I examine respondent's own childhood adversity as well as their partner's childhood adversity (poor childhood health, parental divorce, or father's long-term unemployment) on respondent's subjective well-being, at aged 50 and older.

RESULTS

Findings from the actor-partner interdependence model (APIM) show poor childhood health of the male partner as associated with worse mental health and self-rated health of the female partner in later life. For both outcome measures, the partner effects were attenuated after adjusting for the female partner's report of perceived social support. For self-rated health, adjusting for variation in the presence of a chronic illness and household income also attenuated the association.

DISCUSSION

Partnered individuals are nested within a specific context, whereby stress and implications of early life disadvantage may be conceptualized at the couple-level. Future research that assesses how early life experiences of individuals may have implications for family members' later-life well-being may be valuable.