The long arm of childhood: The influence of early-life social conditions on men’s mortality

Long-term effects of health during childhood on depressive symptoms in later life: evidence from a nationally representative survey in China

BACKGROUND

Childhood health significantly influences mental well-being in later life, but this relationship remains underexplored in China. This study aims to investigate the long-term associations between childhood health status and depressive symptoms in older adults, emphasizing the need for early interventions to promote lifelong mental health.

METHODS

We utilized data from a nationally representative survey conducted across 28 provinces of China, comprising 15,581 adults aged 45 years and older. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale. Logistic regression and decision tree models were applied to examine the association between childhood health and depressive symptoms in later life.

RESULTS

The overall prevalence of depressive symptoms among participants was 33.75%. Those reporting excellent or very good childhood health had a lower prevalence (29.99%), while those with poor childhood health reported a markedly higher rate (47.57%). After adjusting for demographics and lifestyle factors, poor childhood health was associated with a higher likelihood of depressive symptoms (AOR 1.83, 95% CI 1.56-2.14, P < 0.0001). Other risk factors included aged 65-74 years (AOR 1.23, 95% CI 1.10-1.38, P = 0.0009), female gender (AOR 2.01, 95% CI 1.78-2.28, P < 0.0001), and never drinking (AOR 1.24, 95% CI 1.11-1.38, P = 0.0012). Protective factors included tertiary education (AOR 0.45, 95% CI 0.32-0.65, P = 0.0030), higher BMI (BMI 24-27.9 kg/m2: AOR 0.72, 95% CI 0.60-0.87 kg/m2, P = 0.0033; BMI ≥ 28 kg/m2: AOR 0.69, 95% CI 0.56-0.85 kg/m2, P = 0.0030), sleep duration of seven or more hours (7-10 h sleep: AOR 0.52, 95% CI 0.48-0.57, P < 0.0001; ≥10 h sleep: AOR 0.50, 95% CI 0.43-0.58, P < 0.0001), never smoked (AOR 0.77, 95% CI 0.68-0.86, P < 0.0001), and urban residency (AOR 0.57, 95% CI 0.50-0.64, P < 0.0001). The decision tree model highlighted key factors associated with depressive symptoms, including childhood health, non-communicable diseases, sleep duration, residency, alcohol consumption, and smoking status.

CONCLUSIONS

Our findings suggest that childhood health may influence mental well-being in later life. Promoting healthy behaviors from early childhood could help reduce depression risk in older age. However, the reliance on self-reported data and a cross-sectional design limit causal interpretation. Preventive care and targeted interventions for vulnerable children should be prioritized to improve long-term mental health outcomes.

Social Mobility and Health-Related Quality of Life Trajectory Classes Among Older Women and Men

OBJECTIVES

Changes in socioeconomic status (SES) during life may impact health in old age. We investigated whether social mobility and childhood and adulthood SES are associated with trajectories of health-related quality of life (HrQoL) over a 17-year period.

METHODS

We used data from the Helsinki Birth Cohort Study (n = 2003, 46% men, mean age 61.5 years). Social mobility was derived from childhood SES, obtained from healthcare records, and register-based adulthood SES.

RESULTS

Logistic regression models showed that lower adulthood SES was associated with lower physical HrQoL trajectories. Among men low (OR 3.95, p < .001), middle (OR 2.20, p = .006), and declining lifetime SES (OR 2.41, p = .001) were associated with lower physical HrQoL trajectories compared to men with high SES. Socioeconomic status was not associated with mental HrQoL trajectories.

DISCUSSION

Declining SES during life course may have negative health consequences, while improving SES is potentially as beneficial as high SES to later-life health among men.

Offspring Education and Parents' COVID-19 Vaccination

Studies on COVID-19 vaccine uptake often focus on individual characteristics; however, fewer studies have assessed how the characteristics of family members might matter for vaccine decisions. This study employs a "social foreground" perspective to ask how the resources of adult children are associated with COVID-19 vaccine uptake among older adult parents. Using data from the U.S. Health and Retirement Study (N = 8086), we find that having a most-educated child who completes college is positively associated with parents' vaccine uptake when compared to having a most-educated child who did not complete college. This association is driven by respondents who themselves have a high school education or less, supporting resource substitution theory. Findings from this study extend the social foreground perspective to offer new insight into the health behaviors of older adults during pandemics.

Walking to the same winter: Urban-rural disparities in pain among middle-aged and older Chinese

Chronic pain, as a barometer of population health, remains understudied from a socio-structural lens. This study adopts a life course perspective and integrates hukou as a potential institutional arrangement shaping pain, aiming to advance the understanding of health inequalities in China. Specifically, we examine urban-rural disparities in pain prevalence and investigate how these disparities evolve across the life course by using generalized estimating equations and the China Health and Retirement Longitudinal Study 2011-2020 (N = 16479). Our findings indicate that rural hukou holders experience more pain than their urban counterparts. Among rural hukou holders, urban dwelling is associated with a reduced pain risk. Furthermore, we observe that pain prevalence increases with age, yet such pain trajectories vary across urban and rural populations, showing a converging trend in pain over the life course. This study extends the literature on health inequalities by demonstrating how institutional and geographic characteristics jointly shape urban-rural gradients in pain prevalence. Moreover, it provides novel evidence for the age-as-leveler hypothesis in a non-Western context.

Linking the 1940 U.S. Census to the National Social Life, Health, and Aging Project: Novel Opportunity to Understand the Effects of Early-Life Residential Environment on Cognitive Aging

OBJECTIVES

The 1940 Census is a valuable resource for understanding various aspects of historical populations in the United States. Recently, the National Social Life, Health and Aging Project integrated 1940 Census data into its extensive data set, providing researchers with an opportunity to explore new avenues of life course investigation. We leverage the newly introduced measures of childhood residential environment and evaluate their potential predictive utility in older adult cognitive functioning net of childhood and adulthood characteristics known to be key risk factors for poor cognition.

METHODS

We analyzed 777 respondents who were children in 1940 (age <17) that have been linked to the 1940 U.S. Census. We used childhood geographic location, homeownership status, household composition, and parental nativity as predictors. Cognitive function was measured using the Montreal Cognitive Assessment.

RESULTS

Regression analysis showed that growing up in an urban area was associated with better cognitive function, while being born in the South was linked to poorer cognitive function, even after controlling for childhood health, parental education, educational attainment, stroke, and smoking status. Additionally, childhood multigenerational household was associated with better cognitive function, and childhood family size was associated with poorer cognitive function. However, these associations became statistically insignificant with the inclusion of educational attainment. We did not find homeownership and parental nativity to be associated with cognitive function.

DISCUSSION

The findings may shed light on the potential long-term effects of childhood circumstances on cognitive aging processes. Implications for current literature and directions for future research are discussed.

Geographical variation in the long-arm of childhood

Scholars have documented the lasting impact of childhood socioeconomic status (SES) on health, but few studies have considered how state contexts in childhood shape health trajectories based on childhood SES across the life course. The current project uses data from the Panel Study of Income Dynamics, 2009-2021 (N = 18,227 person-year observations of adults aged 18-41) to build on these studies by 1) examining state variation in the relationship between childhood SES and adult self-rated health, and 2) assessing the contributions of childhood state-level economic context in moderating this relationship. Logistic regression models first confirmed the expected relationship between childhood SES and adult self-rated health that parallels other literature (OR = 1.79, 95% CI 1.46, 2.19). Of the 37 states included in the analysis, there was a statistically significant difference in reporting poor health between low and high-childhood SES groups in 14 states. The interaction between childhood SES and state-level income inequality (OR = .01, 95% CI -9.77, -.62), suggests that exposure to higher levels of income inequality in childhood was more harmful for the health of individuals from higher SES backgrounds. The interaction between childhood SES and unemployment rates (OR = 1.13, 95% CI 1.03, 1.24), suggests that exposure to higher unemployment rates in childhood was more harmful for the health of individuals from lower SES backgrounds. This study finds important state-variation in the relationship between childhood SES and adult health and identifies income inequality and unemployment rates as factors in these differences.

Life course socioeconomic position and care dependency in later life: a longitudinal multicohort study from 17 countries

Background

Care dependency, inability to perform basic daily tasks without assistance due to functional impairment, increases substantially with accelerated population ageing and becomes a pressing public health concern worldwide. Socioeconomic disadvantage has been shown to be associated with elevated risks of care dependency, but how risks are modified by changes in socioeconomic position remains unclear. From a life course perspective, we investigated the association between socioeconomic mobility across the lifespan and care dependency in later life.

Methods

In this longitudinal multicohort study, we pooled data collected between 2000 and 2019 from six prospective cohort studies across 17 countries from the Program on Global Ageing, Health, and Policy. Socioeconomic status (SES) at three different life stages was assessed based on parental education in childhood, participants' education in early adulthood, and non-housing wealth in middle-late adulthood. Care dependency was measured using activities of daily living (ADLs) and instrumental activities of daily living (IADLs) following WHO recommendations. Ordinal logistic mixed-effect models were applied to investigate associations between socioeconomic inequalities and their mobility across the life course with later-life care dependency. Furthermore, to investigate contributors to inequalities in care dependency, we applied the difference method to estimate the proportion of these inequalities explained by potential risk factors, and quantified the health and economic benefits of targeted interventions using population attributable fractions.

Findings

A total of 103,282 individuals were involved in this study, with an average baseline age of 63.29 (SD 10.70) years and a mean follow-up of 8.75 (SD 0.02) years. Low SES at any stage of life was associated with elevated probability, increased severity, and accelerated deterioration of care dependency in later life, with women being particularly vulnerable. For the probability of IADL dependency, socioeconomic differences by parental education persisted and were greatest at ages 75-80 years (18.10%, 95% CI 14.25%-21.95% for women; 10.23%, 5.82%-14.64% for men). Considering the severity of dependency, differences in low ADL dependency reversed in advanced old age, while differences in high ADL dependency widened consistently with age. Differences in high ADL dependency between high and low childhood SES groups increased from 0.66% (0.64%-0.67%) at age 50 to 15.79% (12.19%-19.39%) at age 100. Compared with a stable high SES throughout life, all other SES mobility trajectories were associated with elevated risks of both IADL and ADL dependency. Individuals who experienced a severe SES decline-high in childhood but low in adulthood-showed a more than ten times higher risk (IADL: OR 18.26, 95% CI 12.45-26.79; ADL: 11.95, 8.47-16.88). A lower risk was observed for those who moved from low SES in childhood to high SES in adulthood (IADL: 2.51, 1.00-6.33; ADL: 1.52, 0.62-3.72). Furthermore, out of risk factors ranging from lifestyles, diseases to social connections, lack of social activities was found to be the primary contributor to socioeconomic inequalities in care dependency (explaining up to 66.63%), with corresponding interventions achieving universal health and economic benefits across countries.

Interpretation

Changing socioeconomic status over the lifespan was associated with care dependency risk in later life. Promoting equal educational opportunities from an early age to equitably benefit the most socioeconomically disadvantaged could help mitigate care burdens. Encouraging participation in social activities has the potential to reduce socioeconomic differences in care dependency.

Funding

National Natural Science Foundation of China.

Childhood socioeconomic position and healthy ageing: results from five harmonised cohort studies in the ATHLOS consortium

Introduction

Childhood socioeconomic position (SEP) has been identified as a key determinant of health. However, earlier literature is largely from high-income countries and provides limited evidence on the prolonging impacts of childhood disadvantage on healthy ageing across diverse settings and populations. The aim of this study is to investigate the associations between childhood SEP and healthy ageing across multiple countries and the mediation effects of adult SEP, individual education and wealth, on these associations.

Methods

Using the harmonised dataset of five cohort studies in the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, this study was based on 57 956 people aged ≥50 years (women: 53.3%) living in China, Finland, UK, Poland, South Africa and Mexico. The associations between childhood SEP (parental education and occupation) and healthy ageing scores were examined using linear regression modelling. Causal mediation analysis was carried out to estimate the percentage of indirect effects via adult SEP (individual education and wealth).

Results

Higher levels of childhood SEP were associated with higher healthy ageing scores by up to five points and similar patterns were observed across populations from different countries. The associations were mediated by adult SEP and the range of mediation effects was between 21% and 78%.

Conclusions

This study found childhood SEP was associated with poor health in later life across high-income, middle-income and low-income countries. Addressing socioeconomic disadvantage, such as improving education attainment, may moderate the impacts of adversity in early life and support health and functioning in later life.

The contribution of childhood adversity to adult socioeconomic gradients in mortality: A Swedish birth cohort analysis

BACKGROUND

"Child maltreatment is a leading cause of health inequality" according to a leading WHO report. This statement is often assumed, yet, the size of the contribution of childhood adversity to the adult socioeconomic gradient in mortality remains unknown. Inequalities in mortality have mostly been investigated by taking adult conditions as a starting point. The objective of this study is to quantify how much of the socioeconomic gradient in adult life expectancy is associated with childhood adversity.

METHODS

Drawing on a 1953 birth cohort from Stockholm (n = 14 210), we compared inequalities in adult mortality within the full cohort to a counterfactual scenario where individuals with a history of childhood adversity (indicated by involvement with child welfare services) experienced the mortality rates of those achieving the same adult socioeconomic position, but with no history of childhood adversity. The socioeconomic gradient across education and income quintiles (attained by age 29) is measured by the slope index of inequality of temporary life expectancy (ages 29-67).

RESULTS

The counterfactual scenario attenuated the education gradient by 40 percent for men and 54 percent for women. Similarly, inequalities by income were reduced in the counterfactual scenario by 49 percent for men and 47 percent for women.

INTERPRETATION

These results support that childhood adversity is an important determinant of inequalities in mortality. The size of their contribution is equivalent to established behavioural risk factors. Taking a life course approach might provide important policy entry points to mitigate health inequalities.

Study on the age-period-cohort effects of cognitive abilities among older Chinese adults based on the cognitive reserve hypothesis

BACKGROUND

Cognitive abilities serves as a critical indicator of healthy aging. As China progresses into a stage of advanced population aging, there has been a significant increase in the number of elderly individuals experiencing age-related cognitive decline. Despite this demographic shift, there is a paucity of longitudinal research examining cognitive abilities among older Chinese adults over extended time periods. This study aims to investigate changes in cognitive abilities and explore group differences among older Chinese adults aged 65 to 110 years, employing a multidimensional temporal approach that encompasses age, period, and birth cohort effects.

METHODS

This study utilizes data from eight waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), spanning from 1998 to 2018. The dataset comprises 94,116 observations from 36,157 unique participants. Cognitive abilities are assessed using Mini-Mental State Examination (MMSE) scores as a proxy measure. To address the issue of perfect collinearity in the temporal dimension, the study employs the Hierarchical Age-Period-Cohort Cross-Classified Random Effects Model (HAPC-CCREM). This model allows for the examination of age effects, period effects, and cohort effects on cognitive abilities among older Chinese adults. In the model specification, age is treated as a fixed effect, while period and birth cohort are incorporated as random effects. Drawing upon the cognitive reserve hypothesis, the study investigates significant factors influencing cognitive abilities in this population.

RESULTS

At the fixed-effect level, demographic factors, health behaviors, self-rated health, subjective well-being, and childhood adversity significantly influence cognitive abilities among older Chinese adults. The age effects are significant, with cognitive abilities exhibiting an inverted U-shaped curve across the lifespan. At the random-effect level, period effects are significant, revealing a gradual annual increase in overall cognitive levels among older Chinese adults since 2008. Cohort effects are also significant, demonstrating an increasing trend in overall cognitive levels for the earlier-born cohorts in the first six groups. Conversely, later-born cohorts in the latter five groups show a declining trend in overall cognitive levels. Notably, period effects significantly enhance cohort effects.

CONCLUSIONS

The cognitive reserve hypothesis supports the significance of the majority of identified influencing factors. Cognitive abilities demonstrate an accelerating decline with increasing age, following an evolutionary trajectory consistent with physiological principles among older Chinese adults. Since 2008, cognitive abilities have shown a monotonic increasing trend annually, further validating the Flynn effect in this population. The cognitive abilities of the six earlier-born cohorts exhibit an increasing trend, supporting the compression of morbidity hypothesis. Conversely, the cognitive abilities of the five later-born cohorts show a declining trend, supporting the expansion of morbidity hypothesis. These findings collectively contribute to our understanding of cognitive aging patterns and their underlying mechanisms among older Chinese adults.

For Whom Does Education Convey Health Benefits? A Two-Generation and Life Course Approach

Scholars of social determinants of health have long been interested in how parent's and own education influence health. However, the differing effects of parent's and own education on health-that is, for what socioeconomic group education conveys health benefits-are relatively less studied. Using multilevel marginal structural models, we estimate the heterogeneous effects of parent's and own education over the life course on two health measures. Our analysis considers both parent's and respondent's pre-education covariates, such as childhood health and socioeconomic conditions. We find that the protective effects of college completion against negative health outcomes are remarkably similar regardless of parent's (measured by father's or mother's) education. Meanwhile, parent's education has a larger effect when the average educational level is low in the population. Our results also reveal distinct life course patterns between health measures. We conclude by discussing the implications of our study for understanding the education-health relationship.

Economic Disadvantage During Childhood, Obesity, and Diabetes Across Three Birth Cohorts of Older Mexicans

OBJECTIVES

Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in 3 cohorts of Mexican adults.

METHODS

Data on those 60-69 years old from the 1930-1939, 1940-1949, and 1950-1959 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent reports. Supplementary analyses using HbA1c as a criterion for diabetes were conducted. A regression-decomposition approach was implemented. Logistic regression models included adjustments for sociodemographic characteristics and access to medical care.

RESULTS

Diabetes prevalence was 23% overall and 11%, 25%, and 26% in the 1930-1939, 1940-1949, and 1950-1959 cohorts, respectively. EDDC declined across successive cohorts, whereas the prevalence of overweight/obesity at age 50 increased. EDDC and overweight/obesity were associated with higher odds of reporting diabetes. A scenario that eliminates disadvantaged EDDC reduced diabetes prevalence by 11% in a pooled sample, while eliminating overweight/obesity reduced it by 30%. Overweight/obesity explained 42% of the rise in diabetes prevalence between the 1930-1939 and 1950-1959 cohorts. Improvement in EDDC explained 18% of the rise in diabetes prevalence between 1930-1939 and 1950-1959 cohorts.

DISCUSSION

High body weight across Mexican birth cohorts seemed to offset the potential benefits from improvements in childhood conditions on adult diabetes risk.

From one death to another: The relationship between familial deaths and one's own mortality risk among an urban Black American cohort

Black Americans continue to be 1.5 times more likely to experience premature death with life expectancy up to six years shorter than their white American counterparts. These racial disparities in mortality translate into Black Americans being much more likely to experience the deaths of family members at younger ages in the life course. This study examines the impact of experiencing familial death on the survivor's mortality risk among a cohort of Black men and women. Data collected from a community cohort first assessed in 1966 (at age 6) and followed at three additional time points (ages 16, 32, and 42) are supplemented with mortality data, retrieved from the National Death Index, that include deaths through 2021 (modal age 61). Among the 941 participants who survived to age 32 and had information on familial deaths, 38.9% experienced the death of a parent, child, or sibling by age 32, and close to one-fifth (18.2%) died between ages 33 and 61. Cox regression models that adjust for early life covariates revealed a 48% higher mortality risk among those who experienced at least one familial death by age 32; separate models provide evidence that the accumulation of familial deaths is related to midlife mortality risk. Models of relationship type indicate that death of a mother or sibling is associated with a 74% and 77% increase in mortality risk, respectively. Results highlight the heavy burden of premature familial mortality on Black Americans and its adverse impact on one's own life expectancy.

Childhood and adult socioeconomic status influence on late-life healthy longevity: evidence from the Chinese longitudinal healthy longevity survey

Background

Older people in low- and middle-income countries are more susceptible to the impact of childhood experiences. This study comprehensively examines how childhood socioeconomic status (SES) and adult SES collectively influence late-life healthy longevity from a life course perspective, providing insights for shaping health-related policies.

Methods

This study analyzed data from the Chinese Longitudinal Healthy Longevity Survey (1998-2018) with 37,264 individuals aged 65 and above. Using R software, we applied continuous-time multi-state models incorporating the Rockwood frailty index with 38 indicators to assess participants' health. Childhood SES or life course SES trajectories were core explanatory variables, while age and gender were controlled. Multinomial regression estimated annual transition probabilities between different states, and the multi-state life table method calculated total and frailty-specific life expectancy (LE).

Results

(1) Social mobility among older people in China showed an upward trend from childhood to adulthood. (2) Transition probabilities for robust-frailty, robust-dead, and frailty-dead increased with age, while frailty-robust decreased. Transition probabilities and LE varied across different childhood SES (low, medium, high) or life-course SES trajectory categories (low-low, low-medium, low-high, medium-low, medium-medium, medium-high, high-low, high-medium, high-high), with probabilities of robust-frailty, robust-dead, and frailty-dead decreasing sequentially across different categories, and frailty-robust increasing sequentially across different categories. Total LE, robust LE, and robust LE proportion increased sequentially across different categories, while frailty LE decreased sequentially across different categories. (3) Women had higher total LE and frailty incidence, but lower recovery rate, mortality risk, robust LE, and robust LE proportion compared to men.

Conclusion

Favorable childhood SES and lifelong accumulation of SES advantages protect against frailty morbidity, improve recovery rate, reduce mortality risk, and increase total LE, robust LE, and robust LE proportion. High childhood SES has a stronger protective effect than high adult SES, indicating the lasting impact of childhood conditions on healthy longevity. Systematic interventions in education, food supply, and medical accessibility for children from impoverished families are crucial.

Intergenerational transmission of health inequalities: towards a life course approach to socioeconomic inequalities in health - a review

Adult health inequalities are a persistent public health problem. Explanations are usually sought in behaviours and environments in adulthood, despite evidence on the importance of early life conditions for life course outcomes. We review evidence from a broad range of fields to unravel to what extent, and how, socioeconomic health inequalities are intergenerationally transmitted.We find that transmission of socioeconomic and associated health (dis)advantages from parents to offspring, and its underlying structural determinants, contributes substantially to socioeconomic inequalities in adult health. In the first two decades of life-from conception to early adulthood-parental socioeconomic position (SEP) and parental health strongly influence offspring adult SEP and health. Socioeconomic and health (dis)advantages are largely transmitted through the same broad mechanisms. Socioeconomic inequalities in the fetal environment contribute to inequalities in fetal development and birth outcomes, with lifelong socioeconomic and health consequences. Inequalities in the postnatal environment-especially the psychosocial and learning environment, physical exposures and socialisation-result in inequalities in child and adolescent health, development and behavioural habits, with health and socioeconomic consequences tracking into adulthood. Structural factors shape these mechanisms in a socioeconomically patterned and time-specific and place-specific way, leading to distinct birth-cohort patterns in health inequality.Adult health inequalities are for an important part intergenerationally transmitted. Effective health inequality reduction requires addressing intergenerational transmission of (dis)advantage by creating societal circumstances that allow all children to develop to their full potential.

Consequences of deferred action for childhood arrivals for parent health: Applying a social foreground perspective

Objective

This study applies a social foreground perspective to assess whether the Deferred Action for Childhood Arrivals (DACA) program impacted the self-rated health of coresident parents of DACA-eligible individuals.

Background

DACA status grants a temporary work permit and allows for a stay of deportation for undocumented persons who entered the United States as children. Although research points to the positive health benefits of DACA for its recipients, less is known about whether the program affects the health of family members, including parents.

Method

This study uses data from the National Health Interview Study (2008-2015) on foreign-born adults and their coresident parents. We applied a difference-in-differences design to examine whether the self-rated health of coresident mothers and fathers changed following the passage of DACA for DACA-eligible individuals.

Results

In contrast to expectations, DACA was associated with worse self-rated health among coresident, partnered parents. These results may be because DACA also decreased the likelihood of coresiding with parents and changed the composition of coresident parents themselves. Following DACA, fewer eligible offspring lived with parents overall, but among those that did, parents tended to be older and less healthy.

Conclusion

Findings underscore how DACA may be used as a resource to support older parents experiencing health challenges, in particular among older undocumented immigrants, who make up a growing share of the undocumented population in the United States.

Explaining child maltreatment and aggression among Chinese drug user: The mediating and moderating roles of drug craving and impulsivity

BACKGROUND

The cycle of violence highlights a strong correlation between child maltreatment and aggression. However, there remains a significant gap in the pathway models of the cycle of violence. Given the exceptionally high rates of child maltreatment and violent crime among Chinese drug users, it is essential to examine the mechanisms of the cycle of violence within this group.

OBJECTIVE

The current study incorporates drug craving and impulsivity into the child maltreatment-aggression mechanism. We explore the potential mediating and moderating roles of these variables and further examine the heterogeneity.

PARTICIPANTS AND SETTING

A total of 894 participants (Meanage = 38.30, SDage = 8.38) were recruited as the final sample.

METHODS

We employed moderated mediation and serial mediation models to explore the roles of drug craving and impulsivity. The Johnson-Neyman method was utilized to investigate moderating effects. Rich demographic variables and depression were controlled.

RESULTS

There was no direct relationship between child maltreatment and aggression. The moderated mediation model indicated that drug craving played a mediating role, and there was a substitutive relationship between impulsivity and drug craving. The serial mediation model showed that child maltreatment could only affect drug craving (not impulsivity) and could ultimately influence aggression through a chain relationship. Heterogeneity tests revealed that the mechanisms might differ among various types of maltreatment.

CONCLUSION

Drug craving holds a significant position in the cycle of violence. Compared to impulsivity, it is a more proximal factor to child mistreatment. Future research should also focus on the heterogeneity of child maltreatment for targeted interventions.

Do Religion and Spirituality Buffer the Effect of Childhood Trauma on Depressive Symptoms? Examination of a South Asian Cohort from the USA

Asian Americans have been identified as a racial group that is disproportionately affected by childhood trauma. The goal of this study was  to assess if religion/spirituality moderate the effects of childhood trauma on adult depressive symptoms among a sample of South Asians in the USA. Our analysis drew from the study on stress, spirituality, and health (SSSH) questionnaire fielded in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (n = 990) during 2016-2018. A series of regression models with multiplicative interaction terms were conducted. Emotional neglect, emotional abuse, and physical neglect were associated with higher depressive symptoms. Higher religious attendance and negative religious coping techniques were found to exacerbate this relationship. There were two findings conditional on gender. Among men, gratitude and positive religious coping also exacerbated the relationship between childhood trauma and depressive symptoms. Negative religious coping also exacerbated the association between childhood trauma and depressive symptoms for women. This is the first community-based study of US South Asians to consider the association between various forms of childhood trauma and depressive symptom outcomes. South Asians remain an understudied group in the religion and health literature, and this study sheds light on the important differences in the function and effectiveness of religion/spirituality for those faced with early life trauma.

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.

The long-term health effects of childhood exposure to social and economic policies: A scoping review

While numerous studies have found a relationship between social and economic policies and short-term health outcomes, fewer studies have explored the long-term health effects of these policies. Given the important association between childhood circumstances and health in adulthood, long-term population health consequences should be considered when designing social and economic policies. This review summarizes the existing literature on the long-term effects of childhood exposure to social and economic policies on adult health, summarizes the findings, the methods employed, and indicates areas for future research. The review process followed the JBI scoping review protocol and PRISMA-ScR reporting guidelines. The search was conducted in three electronic databases (Web of Science, Pub Med, and SCOPUS), and focused on peer-reviewed manuscripts that studied the effects of policy exposures during childhood on health in adulthood. A total of 3471 articles were collected from the databases and 18 were identified as meeting the eligibility criteria. The most commonly studied policies were safety-net policies (N = 6), followed by education policies (N = 5), civil rights policies (N = 3), government investments (N = 3), and child labor laws (N = 1). The health outcomes varied and included chronic conditions, mental health, mortality, and self-rated health. The studies also overwhelmingly employed causal inference techniques (N = 13), including difference-in-differences study designs and instrumental variable analysis. Most studies found long-term positive effects of policies that provided extra resources to historically under-resourced populations, or policies that aimed to increase equality of opportunity. However, there were some studies with null or mixed findings, especially when examining the long-term health effects of education reform. More literature is needed on this important topic, and now is the time to capitalize on longer follow-up periods in currently available data.

The embodiment of parental death in early life through accelerated epigenetic aging: Implications for understanding how parental death before 18 shapes age-related health risk among older adults

Parental death in early life has been linked to various adverse health outcomes in older adulthood. This study extends prior research to evaluate how parental death in early life is tied to accelerated epigenetic aging, a potentially important biological mechanism from which social and environmental exposures impact age-related health. We used data from the 2016 Venous Blood Study (VBS), a component of the Health and Retirement Study (HRS), to examine the association between parental death in early life and accelerated epigenetic aging as measured by three widely used epigenetic clocks (PCPhenoAge, PCGrimAge, and DunedinPACE). We also assessed whether some of the association is explained by differences in educational attainment, depressive symptoms, and smoking behavior. Methods included a series of linear regression models and formal mediation analysis. Findings indicated that parental death in early life is associated with accelerated epigenetic aging for PCPhenoAge and DunedinPACE. The inclusion of educational attainment, depressive symptoms, and smoking behavior attenuated this association, with formal mediation analysis providing additional support for these observations. Parental death in early life may be one of the most difficult experiences an individual may face. The elevated biological risk associated with parental death in early life may operate through immediate changes but also through more downstream risk factors. This study highlights how early life adversity can set in motion biological changes that have lifelong consequences.

Youth Experiencing Parental Death Due to Drug Poisoning and Firearm Violence in the US, 1999-2020

Importance

Youth (those aged <18 years) parental death has been associated with negative health outcomes. Understanding the burden of parental death due to drug poisoning (herein, drugs) and firearms is essential for informing interventions.

Objective

To estimate the incidence of youth parental death due to drugs, firearms, and all other causes.

Design, Setting, and Participants

This cross-sectional observational study was conducted using vital registration, including all US decedents, and census data from January 1990 through December 2020. Data were analyzed from May 30, 2023, to March 28, 2024.

Exposures

Parental death due to drug poisoning or firearms.

Main Outcomes and Measures

A demographic matrix projection model was used to estimate the number and incidence of youth experiencing parental death, defined as the death of 1 or more parents, per 1000 population aged less than 18 years. Analyses evaluated parental deaths by drugs, firearms, and all other causes from 1999 through 2020 by race and ethnicity.

Results

Between 1999 and 2020, there were 931 785 drug poisoning deaths and 736 779 firearm-related deaths with a mean (SD) age of 42.6 (16.3) years. Most deaths occurred among males (73.8%) and White decedents (70.8%) followed by Black (17.5%) and Hispanic (9.5%) decedents. An estimated 759 000 (95% CI, 722 000-800 000) youth experienced parental death due to drugs and an estimated 434 000 (95% CI, 409 000-460 000) youth experienced parental death due to firearms, accounting for 17% of all parental deaths. From 1999 to 2020, the estimated number of youth who experienced parental death increased 345% (95% CI, 334%-361%) due to drugs and 39% (95% CI, 37%-41%) due to firearms compared with 24% (95% CI, 23%-25%) due to all other causes. Black youth experienced a disproportionate burden of parental deaths, based primarily on firearm deaths among fathers. In 2020, drugs and firearms accounted for 23% of all parental deaths, double the proportion in 1999 (12%).

Conclusions and Relevance

Results of this modeling study suggest that US youth are at high and increasing risk of experiencing parental death by drugs or firearms. Efforts to stem this problem should prioritize averting drug overdoses and firearm violence, especially among structurally marginalized groups.

Developmental epigenomic effects of maternal financial problems

Early-life adversity as neglect or low socioeconomic status is associated with negative physical/mental health outcomes and plays an important role in health trajectories through life. The early-life environment has been shown to be encoded as changes in epigenetic markers that are retained for many years.We investigated the effect of maternal major financial problems (MFP) and material deprivation (MD) on their children's epigenome in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Epigenetic aging, measured with epigenetic clocks, was weakly accelerated with increased MFP. In subsequent EWAS, MFP, and MD showed strong, independent programing effects on children's genomes. MFP in the period from birth to age seven was associated with genome-wide epigenetic modifications on children's genome visible at age 7 and partially remaining at age 15.These results support the hypothesis that physiological processes at least partially explain associations between early-life adversity and health problems later in life. Both maternal stressors (MFP/MD) had similar effects on biological pathways, providing preliminary evidence for the mechanisms underlying the effects of low socioeconomic status in early life and disease outcomes later in life. Understanding these associations is essential to explain disease susceptibility, overall life trajectories and the transition from health to disease.

Separating Scarring Effect and Selection of Early-Life Exposures With Genetic Data

Causal life course research examining consequences of early-life exposures has largely relied on associations between early-life environments and later-life outcomes using exogenous environmental shocks. Nonetheless, even with (quasi-)randomized early-life exposures, these associations may reflect not only causation ("scarring") but also selection (i.e., which members are included in data assessing later life). Investigating this selection and its impacts on estimated effects of early-life conditions has, however, often been ignored because of a lack of pre-exposure data. This study proposes an approach for assessing and correcting selection, separately from scarring, using genetic measurements. Because genetic measurements are determined at the time of conception, any associations with early-life exposures should be interpreted as selection. Using data from the UK Biobank, we find that in utero exposure to a higher area-level infant mortality rate is associated with genetic predispositions correlated with better educational attainment and health. These findings point to the direction and magnitude of selection from this exposure. Corrections for this selection in examinations of effects of exposure on later educational attainment suggest underestimates of 26-74%; effects on other life course outcomes also vary across selection correction methods.

The Impact of Cash Transfers to Poor Mothers on Family Structure and Maternal Well-Being

We use newly collected data for 16,000 women who applied for Mothers' Pensions, America's first welfare program, to investigate the effect of means-tested cash transfers on lifetime family structure and maternal well-being. In the short term, cash transfers delayed marriage and lowered geographic mobility. In the long run, transfers had no impact on the probability of remarriage, spouse quality, or fertility. Cash transfers did not affect women's well-being, measured by longevity and family income in 1940. Given the lack of significant negative behavioral impacts, the benefits of transfers appear to exceed costs if they have-even modest-positive impacts on children.

Prevalence and associated factors of adverse childhood experiences (ACE) in a sample of Brazilian university students

BACKGROUND

Adverse childhood experiences (ACEs) have long been associated with health risk behaviors, but they are poorly studied in Brazilian university students.

OBJECTIVE

To estimate the prevalence of ACEs and investigate their association with sociodemographic data, health risk factors and self-related health in a sample of university students.

PARTICIPANTS AND SETTING

A cross-sectional study conducted with 546 students from a Brazilian public university.

METHOD

The self-reported 10-ACE Study questionnaire (ACE-Q) and sociodemographic information (age, sex, family income), health risk factors (body mass index, physical exercise, alcohol and tobacco use) and self-related health were assessed. Chi-square Test and multivariate logistic regression were used to evaluate the association between the cumulative occurrence of ACE (ACE ≥4) and the studied factors.

RESULTS

Of the 546 participants, 464 responded to all ACE-Q questions; 74.4% reported at least one ACE, and 13.1 % reported four or more. Lower family income (OR = 2.02; 95%CI = 1.13-3.61; p = 0.01) and self-related poor health (OR = 2.29; 95%CI = 1.28-4.08; p = 0.00) were associated with the occurrence of ACE ≥4.

CONCLUSION

Most students reported at least one ACE, while a minority reported ≥4 ACEs associated with lower family income and poor self-health. The data suggest that preventive actions should be considered to mitigate the problem, with lower-income students being treated as a priority.

Utilizing epigenetics to study the shared nature of development and biological aging across the lifespan

Recently, biological aging has been quantified in DNA-methylation samples of older adults and applied as so-called "methylation profile scores" (MPSs) in separate target samples, including samples of children. This nascent research indicates that (1) biological aging can be quantified early in the life course, decades before the onset of aging-related disease, (2) is affected by common environmental predictors of childhood development, and (3) shows overlap with "developmental processes" (e.g., puberty). Because the MPSs were computed using algorithms developed in adults, these studies indicate a molecular link between childhood environments, development, and adult biological aging. Yet, if MPSs can be used to connect development and aging, previous research has only traveled one way, deriving MPSs developed in adults and applying them to samples of children. Researchers have not yet quantified epigenetic measures that reflect the pace of child development, and tested whether resulting MPSs are associated with physical and psychological aging. In this perspective I posit that combining measures of biological aging with new quantifications of child development has the power to address fundamental questions about life span: How are development and experience in childhood related to biological aging in adulthood? And what is aging?

Childhood adverse life events and skeletal muscle mitochondrial function

Social stress experienced in childhood is associated with adverse health later in life. Mitochondrial function has been implicated as a mechanism for how stressful life events "get under the skin" to influence physical well-being. Using data from the Study of Muscle, Mobility, and Aging (n = 879, 59% women), linear models examined whether adverse childhood events (i.e., physical abuse) were associated with two measures of skeletal muscle mitochondrial energetics in older adults: (i) maximal adenosine triphosphate production (ATPmax) and (ii) maximal state 3 respiration (Max OXPHOS). Forty-five percent of the sample reported experiencing one or more adverse childhood events. After adjustment, each additional event was associated with -0.08 SD (95% confidence interval = -0.13, -0.02) lower ATPmax. No association was observed with Max OXPHOS. Adverse childhood events are associated with lower ATP production in later life. Findings indicate that mitochondrial function may be a mechanism for understanding how early social stress influences health in later life.

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.

The effects of education on mortality: Evidence using college expansions

This paper explores the long-run health benefits of education for longevity. Using mortality data from the Social Security Administration (1988-2005) linked to geographic locations in the 1940-census data, we exploit changes in college availability across cohorts in local areas. Our treatment on the treated calculations suggest increases in longevity between 1.3 and 2.7 years. Some further analyses suggest the results are not driven by pre-tends, endogenous migration, and other time-varying local confounders. This paper adds to the literature on the health and social benefits of education.

Association Between Changes in Racial Residential and School Segregation and Trends in Racial Health Disparities, 2000-2020: A Life Course Perspective

INTRODUCTION

Most studies of the relationship between racial segregation and racial health disparities have focused on residential segregation. School-based racial segregation is an additional form of segregation that may be associated with racial disparities in health. This study examines the relationship between both residential segregation and school segregation and racial health disparities among non-Hispanic Black compared to non-Hispanic White persons at the county level in the United States. It also examines the relationship between changes in residential and school segregation and subsequent trajectories in a variety of racial health disparities across the life course.

METHODS

Using the CDC WONDER Multiple Case of Death database, we derived an annual estimate of race-specific death rates and rate ratios for each county during the period 2000-2020. We then examined the relationship between baseline levels of residential and school segregation in 1991 as well as changes between 1991-2000 and the trajectories of the observed racial health disparities between 2000 and 2020. We used latent trajectory analysis to identify counties with similar patterns of residential and school segregation over time and to identify counties with similar trajectories in each racial health disparity. Outcomes included life expectancy, early mortality (prior to age 65), infant mortality, firearm homicide, total homicide, and teenage pregnancy rates.

RESULTS

During the period 1991-2020, racial residential segregation remained essentially unchanged among the 1051 counties in our sample; however, racial school segregation increased during this period. Increases in school segregation from 1991 to 2000 were associated with higher racial disparities in each of the health outcomes during the period 2000-2020 and with less progress in reducing these disparities.

CONCLUSION

This paper provides new evidence that school segregation is an independent predictor of racial health disparities and that reducing school segregation-even in the face of high residential segregation-could have a long-term impact on reducing racial health disparities. Furthermore, it suggests that the health consequences of residential segregation have not been eliminated from our society but are now being exacerbated by a new factor: school-based segregation. Throughout this paper, changes in school-based segregation not only show up as a consistent significant predictor of greater racial disparities throughout the life course, but at times, an even stronger predictor of health inequity than residential segregation.

Early Life Stress Is Associated with Alterations in Lymphocyte Subsets Independent of Increased Inflammation in Adolescents

Early life stress (ELS) is linked to an elevated risk of poor health and early mortality, with emerging evidence pointing to the pivotal role of the immune system in long-term health outcomes. While recent research has focused on the impact of ELS on inflammation, this study examined the impact of ELS on immune function, including CMV seropositivity, inflammatory cytokines, and lymphocyte cell subsets in an adolescent cohort. This study used data from the Early Life Stress and Cardiometabolic Health in Adolescence Study (N = 191, aged 12 to 21 years, N = 95 exposed to ELS). We employed multiple regression to investigate the association between ELS, characterized by early institutional care, cytomegalovirus (CMV) seropositivity (determined by chemiluminescent immunoassay), inflammation (CRP, IL-6, and TNF-a determined by ELISA), and twenty-one immune cell subsets characterized by flow cytometry (sixteen T cell subsets and five B cell subsets). Results reveal a significant association between ELS and lymphocytes that was independent of the association between ELS and inflammation: ELS was associated with increased effector memory helper T cells, effector memory cytotoxic T cells, senescent T cells, senescent B cells, and IgD- memory B cells compared to non-adopted youth. ELS was also associated with reduced percentages of helper T cells and naive cytotoxic T cells. Exploratory analyses found that the association between ELS and fewer helper T cells and increased cytotoxic T cells remained even in cytomegalovirus (CMV) seronegative youth. These findings suggest that ELS is associated with cell subsets that are linked to early mortality risk in older populations and markers of replicative senescence, separate from inflammation, in adolescents.

On religious ambiguity: Childhood family religiosity and adult flourishing in a twin sample

Ambiguity is an important notion in sociology, denoting situations where social actors and groups carry on without shared meaning. The current article applies this concept to the context of religiosity during people's upbringing, recognizing that multiple factors make family-level religion a complex experience. Indeed, though recent research portrays household religiosity in childhood as a sociocultural exposure with long-term implications for well-being, existing studies have yet to incorporate multiple inputs to consider the cohesiveness of that exposure. Using twin data from a national sample, we investigate whether consistency in recalled household religiosity is associated with mid-life flourishing. Multi-level linear regression models reveal that similarity in twin reports matter, above and beyond the actual level of religiosity individuals report and net of dis/similarity across other childhood recollections. We conclude that coherence in religious upbringing-whether religion was understood to be important or not-is a key ingredient for thriving later in life and then reflect more broadly on manifestations of sociocultural ambiguity in families and in larger social units.

The Siren Song of Cicadas: Early-Life Pesticide Exposure and Later-Life Male Mortality

This paper studies the long-term effects of in-utero and early-life exposure to pesticide use on adulthood and old-age longevity. We use the cyclical emergence of cicadas in the eastern half of the United States as a shock that raises the pesticide use among tree crop growing farmlands. We implement a difference-in-difference framework and employ Social Security Administration death records over the years 1975-2005 linked to the complete count 1940 census. We find that males born in top-quartile tree-crop counties and exposed to a cicada event during fetal development and early-life live roughly 2.2 months shorted lives; those with direct farm exposure face a reduction of nearly a year. We provide empirical evidence to examine mortality selection before adulthood, endogenous fertility, and differential data linkage rates. Additional analyses suggests that reductions in education and income during adulthood are potential mechanisms of impact. Our findings add to our understanding of the relevance of early-life insults for old-age health and mortality.

Life-course socio-economic status and its impact on functional health of Portuguese older adults

Functional health is arguably one of the most important health indicators for older adults, because it assesses physical, cognitive and social functions in combination. However, life-course circumstances may impact this multidimensional construct. The aim of the present study was to assess the relationship between life-course socio-economic status (SES) and different dimensions of functional health in older adults. Data on 821 Portuguese adults aged 50 years and over in 2013-2015 were analysed. Life-course SES was computed using participants' paternal occupation (non-manual (nm); manual (m)) and own occupation (nm; m), resulting in four patterns: stable high (nm + nm), upward (m + nm), downward (nm + m) and stable low (m + m). Functional health included physical and mental functioning, cognitive function, handgrip strength, and walking speed. Linear (beta coefficients) and logistic regressions (odds ratios) were used to estimate the association between life-course SES and functional health.Overall, those who accumulated social disadvantage during life-course presented worse functional health than those with stable high SES (stable low - SF-36 physical functioning: β = -9.75; 95% CI: -14.34; -5.15; SF-36 mental health: β = -7.33; 95% CI: -11.55; -3.11; handgrip strength: β = -1.60; 95% CI: -2.86; -0.35; walking time, highest tertile: OR = 5.28; 95% CI: 3.07; 9.09). Those with an upward SES were not statistically different from those in the stable high SES for most of the health outcomes; however, those with an upward SES trajectory tended to have higher odds of cognitive impairment (OR = 1.75; 95% CI: 0.96; 3.19). A downward SES trajectory increased the odds of slower walking speed (OR = 4.62; 95% CI: 1.78; 11.95). A disadvantaged life-course SES impacts older adults' physical and mental functioning. For some outcomes, this was attenuated by a favourable adulthood SES but those with a stable low SES consistently presented worse functional health.

Three common assumptions about inflammation, aging, and health that are probably wrong

Chronic inflammation contributes to the onset and progression of cardiovascular disease and other degenerative diseases of aging. But does it have to? This article considers the associations among inflammation, aging, and health through the lens of human population biology and suggests that chronic inflammation is not a normal nor inevitable component of aging. It is commonly assumed that conclusions drawn from research in affluent, industrialized countries can be applied globally; that aging processes leading to morbidity and mortality begin in middle age; and that inflammation is pathological. These foundational assumptions have shifted focus away from inflammation as a beneficial response to infection or injury and toward an understanding of inflammation as chronic, dysregulated, and dangerous. Findings from community-based studies around the world-many conducted in areas with relatively high burdens of infectious disease-challenge these assumptions by documenting substantial variation in levels of inflammation and patterns of association with disease. They also indicate that nutritional, microbial, and psychosocial environments in infancy and childhood play important roles in shaping inflammatory phenotypes and their contributions to diseases of aging. A comparative, developmental, and ecological approach has the potential to generate novel insights into the regulation of inflammation and how it relates to human health over the life course.

Long-term effects of the left-behind experience on health and its mechanisms: Empirical evidence from China

Previous studies have primarily focused on the contemporaneous, short-term and medium-term effects of the childhood left-behind experience on subsequent health, but ignored its long-term effects and the mediating mechanisms of health outcomes. Using nationally representative data from the 2018 China Labor-force Dynamic Survey, this study uses self-rated health as a measure of health outcomes to examine the long-term effects of the left-behind experience and elucidate the underlying mechanisms that contribute to health inequality from a life-course perspective. The results show: (1) the childhood left-behind experience exerts a long-term negative impact on self-rated health in adulthood, and this impact persists and does not fade over time after ending the left-behind status; (2) the influence of the childhood left-behind experience on self-rated health demonstrates a cumulative disadvantage effect, with longer duration of being left-behind resulting in greater negative impacts; additionally, there's a critical window effect, with earlier left-behind experience leading to more significant negative outcomes; (3) the experience of being left behind during childhood has a negative impact and threshold effect on social trust in adulthood, meaning that the left-behind experience negatively affects social trust, but the duration of being left behind doesn't exacerbate this reduction; and (4) social trust is a key mediating factor between left-behind experiences and health, explaining 8.70% of this effect, and explaining 12.15% and 7.71% of mediation effects for adults with left-behind experience in middle and primary school stages, respectively.

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.

Environmental, sex-specific and genetic determinants of infant social behaviour in a wild primate

Affiliative social bonds are linked to fitness components in many social mammals. However, despite their importance, little is known about how the tendency to form social bonds develops in young animals, or if the timing of development is heritable and thus can evolve. Using four decades of longitudinal observational data from a wild baboon population, we assessed the environmental determinants of an important social developmental milestone in baboons-the age at which a young animal first grooms a conspecific-and we assessed how the rates at which offspring groom their mothers develops during the juvenile period. We found that grooming development differs between the sexes: female infants groom at an earlier age and reach equal rates of grooming with their mother earlier than males. We also found that age at first grooming for both sexes is weakly heritable (h2 = 0.043, 95% CI: 0.002-0.110). These results show that sex differences in grooming emerge at a young age; that strong, equitable social relationships between mothers and daughters begin very early in life; and that age at first grooming is heritable and therefore can be shaped by natural selection.

Sequencing of Births by Wantedness: Implications for Changes in Mid-Life Health Among Aging NLSY79 Women

OBJECTIVES

As life course frameworks highlight and gerontological studies confirm, the health implications of early birth timing (e.g., adolescent births) and unplanned births (e.g., unwanted or mistimed births) extend years after those births into mid and later life. Yet past research often overlooks the considerable diversity in sequencing and timing of unplanned births even within the same individual (e.g., having both wanted and unwanted births), which are likely fundamental for women's long-term health trajectories. We develop a holistic understanding of birth timing and wantedness to provide insight into when and how childbearing histories matter for aging women's health.

METHODS

We use sequence analysis with hierarchical cluster method and estimate regression models using the 1979 National Longitudinal Survey of Youth (N = 3,231) to examine how timing and patterning of births by wantedness are associated with changes in physical and mental health from ages 40 to 50.

RESULTS

We identify 7 clusters of childbearing sequences. Of those 7 clusters, respondents with sequences characterized by wanted births in their 20s and 30s had the smallest declines in health in mid-life, whereas respondents with sequences with mainly unwanted births at any age or with mainly mistimed births beginning in adolescence had the greatest health declines. Adjusting for social and economic variables accounted for some, but not all, health differences across childbearing clusters.

DISCUSSION

This project demonstrates the need for comprehensive life course perspectives on long-term health implications of birth wantedness and timing, recognizing diversity within and between individuals.

Childhood adverse life events and skeletal muscle mitochondrial function

Social stress experienced in childhood is associated with adverse health later in life. Mitochondrial function has been implicated as a mechanism for how stressful life events "get under the skin" to influence physical wellbeing. Using data from the Study of Muscle, Mobility and Aging (n=879, 59% women), linear models examined whether adverse childhood events (i.e., physical abuse) were associated with two measures of skeletal muscle mitochondrial energetics in older adults: (1) maximal adenosine triphosphate production (ATP max ) and (2) maximal state 3 respiration (Max OXPHOS). Forty-five percent of the sample reported experiencing 1+ adverse childhood event. After adjustment, each additional event was associated with -0.07 SD (95% CI= - 0.12, -0.01) lower ATP max . No association was observed with Max OXPHOS. Adverse childhood events are associated with lower ATP production in later life. Findings indicate that mitochondrial function may be a mechanism in understanding how early social stress influences health in later life.

Stability of DNA-Methylation Profiles of Biological Aging in Children and Adolescents

Background and Objectives

Methylation profile scores (MPSs) index biological aging and aging-related disease in adults and are cross-sectionally associated with social determinants of health in childhood. MPSs thus provide an opportunity to trace how aging-related biology responds to environmental changes in early life. Information regarding the stability of MPSs in early life is currently lacking.

Method

We use longitudinal data from children and adolescents ages 8-18 (N = 428, M age = 12.15 years) from the Texas Twin Project. Participants contributed two waves of salivary DNA-methylation data (mean lag = 3.94 years), which were used to construct four MPSs reflecting multi-system physiological decline and mortality risk (PhenoAgeAccel and GrimAgeAccel), pace of biological aging (DunedinPACE), and cognitive function (Epigenetic-g). Furthermore, we exploit variation among participants in whether they were exposed to the COVID-19 pandemic during the course of study participation, in order to test how a historical period characterized by environmental disruption might affect children's aging-related MPSs.

Results

All MPSs showed moderate longitudinal stability (test-retest rs = 0.42, 0.44, 0.46, 0.51 for PhenoAgeAccel, GrimAgeAccel, and Epigenetic-g, and DunedinPACE, respectively). No differences in the stability of MPSs were apparent between those whose second assessment took place after the onset of the COVID-19 pandemic vs. those for whom both assessments took place prior to the pandemic.

Conclusions

Aging-related DNA-methylation patterns are less stable in childhood than has been previously observed in adulthood. Further developmental research on the methylome is necessary to understand which environmental perturbations in childhood impact trajectories of biological aging and when children are most sensitive to those impacts.

Long-run intergenerational health benefits of women empowerment: Evidence from suffrage movements in the US

An ongoing body of research documents that women empowerment is associated with improved outcomes for children. However, little is known about the long-run effects on health outcomes. This paper adds to this literature and studies the association between maternal exposure to suffrage reforms and children's old-age longevity. We utilize changes in suffrage laws across US states and over time as a source of incentivizing maternal investment in children's health and education. Using the universe of death records in the US over the years 1979-2020 and implementing a difference-in-difference econometric framework, we find that cohorts exposed to suffrage throughout their childhood live 0.6 years longer than unexposed cohorts. Furthermore, we show that these effects are not driven by preexisting trends in longevity, endogenous migration, selective fertility, and changes in the demographic composition of the sample. Additional analysis reveals that improvements in education and income are candidate mechanisms. Moreover, we find substantial improvements in early-adulthood socioeconomic standing, height, and height-for-age outcomes due to childhood exposure to suffrage movements. A series of state-level analyses suggest reductions in infant and child mortality following suffrage law change. We also find evidence that counties in states that passed the law experienced new openings of County Health Departments and increases in physicians per capita.

Association between infectious exposures in infancy and epigenetic age acceleration in young adulthood in metropolitan Cebu, Philippines

OBJECTIVES

The drivers of human life expectancy gains over the past 200 years are not well-established, with a potential role for historical reductions in infectious disease. We investigate whether infectious exposures in infancy predict biological aging using DNA methylation-based markers that forecast patterns of morbidity and mortality later in life.

METHODS

N = 1450 participants from the Cebu Longitudinal Health and Nutrition Survey-a prospective birth cohort initiated in 1983-provided complete data for the analyses. Mean chronological age was 20.9 years when venous whole blood samples were drawn for DNA extraction and methylation analysis, with subsequent calculation of three epigenetic age markers: Horvath, GrimAge, and DunedinPACE. Unadjusted and adjusted least squares regression models were evaluated to test the hypothesis that infectious exposures in infancy are associated with epigenetic age.

RESULTS

Birth in the dry season, a proxy measure for increased infectious exposure in the first year of life, as well as the number of symptomatic infections in the first year of infancy, predicted lower epigenetic age. Infectious exposures were associated with the distribution of white blood cells in adulthood, which were also associated with measures of epigenetic age.

CONCLUSIONS

We document negative associations between measures of infectious exposure in infancy and DNA methylation-based measures of aging. Additional research, across a wider range of epidemiological settings, is needed to clarify the role of infectious disease in shaping immunophenotypes and trajectories of biological aging and human life expectancy.

Lost support, lost skills: Children's cognitive outcomes following grandparental death

OBJECTIVE

This study examines the implications of grandparental death for cognitive skills in middle childhood.

METHOD

This study uses data from the Future of Families and Child Wellbeing Study (N = 2479) to estimate ordinary least squares regression models of the associations between grandparental death and subsequent cognitive skills among children in middle childhood.

RESULTS

Experiencing a grandparental death between ages 5 and 9 is associated with boys' lower reading, verbal, and math scores at age 9, with associations most notable for Black and Hispanic boys; grandparental death before age 5 has minimal influence on boys' cognitive skills at age 9. There is little indication that grandparental death adversely affects girls' cognitive skills.

CONCLUSION

The numerous and persistent implications of grandparental death for boys' cognitive skills merit greater recognition of grandparental death as a source of family instability, stress, and ultimately inequality in child development.

Specifying the psychosocial pathways whereby child and adolescent adversity shape adult health outcomes

BACKGROUND

Social scientists generally agree that health disparities are produced, at least in part, by adverse social experiences, especially during childhood and adolescence. Building on this research, we use an innovative method to measure early adversity while drawing upon a biopsychosocial perspective on health to formulate a model that specifies indirect pathways whereby childhood and adolescent adversity become biologically embedded and influence adult health.

METHOD

Using nearly 20 years of longitudinal data from 382 Black Americans, we use repeated-measures latent class analysis (RMLCA) to construct measures of childhood/adolescent adversities and their trajectories. Then, we employ structural equation modeling to examine the direct and indirect effects of childhood/adolescent adversity on health outcomes in adulthood through psychosocial maladjustment.

RESULTS

RMLCA identified two classes for each component of childhood/adolescent adversity across the ages of 10 to 18, suggesting that childhood/adolescent social adversities exhibit a prolonged heterogeneous developmental trajectory. The models controlled for early and adult mental health, sociodemographic and health-related covariates. Psychosocial maladjustment, measured by low self-esteem, depressive and anxiety symptoms, and lack of self-control, mediated the relationship between childhood/adolescent adversity, especially parental hostility, racial discrimination, and socioeconomic class, and both self-reported illness and blood-based accelerated biological aging (with proportion mediation ranging from 8.22% to 79.03%).

CONCLUSION

The results support a biopsychosocial model of health and provide further evidence that, among Black Americans, early life social environmental experiences, especially parenting, financial stress, and racial discrimination, are associated with adult health profiles, and furthermore, psychosocial mechanisms mediate this association.

Salivary Epigenetic Measures of Body Mass Index and Social Determinants of Health Across Childhood and Adolescence

Importance

Children who are socioeconomically disadvantaged are at increased risk for high body mass index (BMI) and multiple diseases in adulthood. The developmental origins of health and disease hypothesis proposes that early life conditions affect later-life health in a manner that is only partially modifiable by later-life experiences.

Objective

To examine whether epigenetic measures of BMI developed in adults are valid biomarkers of childhood BMI and if they are sensitive to early life social determinants of health.

Design, Setting, and Participants

This population-based study of over 3200 children and adolescents aged 8 to 18 years included data from 2 demographically diverse US pediatric cohort studies that combine longitudinal and twin study designs. Analyses were conducted from 2021 to 2022.

Exposures

Socioeconomic status, marginalized groups.

Main Outcome and Measure

Salivary epigenetic BMI, BMI. Analyses were conducted to validate the use of saliva epigenetic BMI as a potential biomarker of child BMI and to examine associations between epigenetic BMI and social determinants of health.

Results

Salivary epigenetic BMI was calculated from 2 cohorts: (1) 1183 individuals aged 8 to 18 years (609 female [51%]; mean age, 13.4 years) from the Texas Twin Project and (2) 2020 children (1011 female [50%]) measured at 9 years of age and 15 years of age from the Future of Families and Child Well-Being Study. Salivary epigenetic BMI was associated with children's BMI (r = 0.36; 95% CI, 0.31-0.40 to r = 0.50; 95% CI, 0.42-0.59). Longitudinal analysis found that epigenetic BMI was highly stable across adolescence but remained both a leading and lagging indicator of BMI change. Twin analyses showed that epigenetic BMI captured differences in BMI between monozygotic twins. Moreover, children from more disadvantaged socioeconomic status (b = -0.13 to -0.15 across samples) and marginalized racial and ethnic groups (b = 0.08-0.34 across samples) had higher epigenetic BMI, even when controlling for concurrent BMI, pubertal development, and tobacco exposure. Socioeconomic status at birth relative to concurrent socioeconomic status best predicted epigenetic BMI in childhood and adolescence (b = -0.15; 95% CI, -0.20 to -0.09).

Conclusion and Relevance

This study demonstrated that epigenetic measures of BMI calculated from pediatric saliva samples were valid biomarkers of childhood BMI and may be associated with early-life social inequalities. The findings are in line with the hypothesis that early-life conditions are especially important factors in epigenetic regulation of later-life health. Research showing that health later in life is linked to early-life conditions has important implications for the development of early-life interventions that could significantly extend healthy life span.

Race-Ethnic Differences in the Effects of COVID-19 on the Work, Stress, and Financial Outcomes of Older Adults

OBJECTIVES

This study investigates race-ethnic differences among older non-Hispanic Black, non-Hispanic White, and Hispanic adults' financial, employment, and stress consequences of COVID-19.

METHODS

We use data from the Health and Retirement Study, including the 2020 COVID-panel, to evaluate a sample of 2,929 adults using a combination of bivariate tests, OLS regression analysis, and moderation tests.

RESULTS

Hispanic and non-Hispanic Black older adults experienced more financial hardships, higher levels of COVID-19 stress, and higher rates of job loss associated with COVID-19 relative to their Non-Hispanic White counterparts. Non-Hispanic Black and Hispanic adults reported significantly higher levels of COVID-19 resilience resources, yet, these resources were not protective of the consequences of COVID-19.

DISCUSSION

Understanding how the experiences of managing and coping with COVID-19 stressors differ by race-ethnicity can better inform intervention design and support services.

Childhood health and educational disadvantage are associated with adult multimorbidity in the global south: findings from a cross-sectional analysis of nationally representative surveys in India and Brazil

INTRODUCTION

Multimorbidity has emerged as a major healthcare challenge in low/middle-income countries (LMICs) such as India and Brazil. Life course epidemiology suggests that adverse events in early life contribute to an individual's later health in adulthood. However, little is known about the influence of early life health and social factors on the development of multimorbidity in adulthood in LMICs. We aimed to explore the association of adult multimorbidity with childhood health and social disadvantages among two LMICs, India and Brazil.

METHODS

We conducted a secondary data analysis of older adults aged ≥50 years using nationally representative surveys from Longitudinal Ageing Study in India, 2017-2018 (n=51 481) and 'Estudo Longitudinal da Saude e Bem-Estar dos Idosos Brasileirous', 2015-2016 (n=8730). We estimated the prevalence of multimorbidity along with 95% CI as a measure of uncertainty for all weighted proportions. Log link in generalised linear model was used to assess the association between childhood health and disadvantages with multimorbidity, reported as adjusted prevalence ratio (APR).

RESULTS

The prevalence of multimorbidity was 25.53% and 55.24% in India and Brazil, respectively. Participants who perceived their childhood health as poor and missed school for a month or more due to illness had the highest level of multimorbidity across both countries. After adjusting for age and gender, a significant association between adult multimorbidity and poor self-rated childhood health (APR: (India: 1.38, 1.16 to 1.65) and (Brazil: 1.19, 1.09 to 1.30)); and missed school for a month due to illness (AOR: (India: 1.73, 1.49 to 2.01) and (Brazil: 1.16, 1.08 to 1.25)) was observed.

CONCLUSION

Early life health, educational and economic disadvantages are associated with adult multimorbidity and appear to contribute to the later course of life. A life course approach to the prevention of multimorbidity in adulthood in LMICs may be useful in health programmes and policies.

Influence of Place of Birth on Adult Mortality: The Case of Spain

We use a unique data set from Spain and we estimate life expectancy at age 50 for males and females by place of residence and place of birth. We show that, consistent with expectations regarding the influence of early conditions on adult health and mortality, the effects of place of birth on adult mortality are very strong, irrespective of place of residence. Furthermore, we find that mortality levels observed in a place are strongly influenced by the composition of migrants by place of birth. This is reflected in a new measure of heritability of early childhood conditions that attains a value in the range 0.42-0.43, implying that as much as 43 percent of the variance in Spain's life expectancy at age 50 is explained by place of birth. Finally, we find evidence of the healthy migrant effect, that is, positive health selection of migrants, at a regional level.