What role for the ‘long arm of childhood’ in social gradients in health? An international comparison of high-income contexts

2020 ◽  
Author(s):  
Steven A. Haas ◽  
Zhangjun Zhou ◽  
Katsuya Oi
Keyword(s):  
Life Course ◽  
Early Life ◽  
Economic Status ◽  
Functional Limitation ◽  
Later Life ◽  
High Income ◽  
Childhood Health ◽  
Relative Contribution ◽  
Early Life Factors

Social gradients in health have been a focus of research for decades. Two important lines of social gradient research have examined (1) international variation in their magnitude and (2) their life course / developmental antecedents. The present study brings these two strands together to explore the developmental origins of educational gradients in health. We leverage data spanning 14 high-income contexts from the Health and Retirement Study and its sisters in Europe. We find that early-life health and socio-economic status consistently attenuate educational gradients in multimorbidity and functional limitation. However, the relative contribution of early-life factors to gradients varies substantially across contexts. The results suggest that research on social gradients, and population health broadly, would benefit from the unique insights available from a conceptual and empirical approach that integrates comparative and life course perspectives.<br /><br />Key messages<br /><ul><li>The magnitude of educational gradients in later life health depend, in part, on childhood health and socioeconomic circumstances.</li><br /><li>The role of early life factors in educational gradients in health varies substantially across high income contexts.</li></ul>

scholarly journals Early-life circumstances and the risk of function-limiting long-term conditions in later life

2020 ◽  
Vol 11 (2) ◽  
pp. 157-180
Author(s):  
Matthew H. Iveson ◽  
Chris Dibben ◽  
Ian J. Deary
Keyword(s):  
Life Course ◽  
Cognitive Ability ◽  
Early Life ◽  
Economic Status ◽  
Functional Limitation ◽  
Later Life ◽  
Socio Economic Status ◽  
Childhood Cognitive Ability ◽  
The Life Course

Older adults are particularly prone to function-limiting health issues that adversely affect their well-being. Previous work has identified factors from across the life course –childhood socio-economic status, childhood cognitive ability and education – that predict later-life functional outcomes. However, the independence of these contributions is unclear as later-in-the-life-course predictors are themselves affected by earlier ones. The present study capitalised on the recent linkage of the Scottish Mental Survey 1947 with the Scottish Longitudinal Study, using path analyses to examine the direct and indirect associations between life-course predictors and the risk of functional limitation at ages 55 (N = 2,374), 65 (N = 1,971) and 75 (N = 1,534). The odds of reporting a function-limiting long-term condition increased across later life. At age 55, reporting a functional limitation was significantly less likely in those with higher childhood socio-economic status, higher childhood cognitive ability and higher educational attainment; these associations were only partly mediated by other predictors. At age 65, adult socio-economic status emerged as a mediator of several associations, although direct associations with childhood socio-economic status and childhood cognitive ability were still observed. At age 75, only childhood socio-economic status and adult socio-economic status directly predicted the risk of a functional limitation, particularly those associated with disease or illness. A consistent pattern and direction of associations was observed with self-rated health more generally. These results demonstrate that early-life and adult circumstances are associated with functional limitations later in life, but that these associations are partly a product of complex mediation between life-course factors.

scholarly journals Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saira Khan ◽  
K. Y. Wolin ◽  
R. Pakpahan ◽  
R. L. Grubb ◽  
G. A. Colditz ◽  
...  
Keyword(s):  
Body Size ◽  
Benign Prostatic Hyperplasia ◽  
Life Course ◽  
Early Life ◽  
Prostate Volume ◽  
Late Life ◽  
Later Life ◽  
Normal Weight ◽  
Prostatic Hyperplasia ◽  
The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

Epidemiologic Trends, Social Determinants, and Brain Health: The Role of Life Course Inequalities

Stroke ◽  
2022 ◽  
Author(s):  
Saima Hilal ◽  
Carol Brayne
Keyword(s):  
Life Course ◽  
Healthy Lifestyle ◽  
Later Life ◽  
Functional Independence ◽  
Health Determinants ◽  
Brain Health ◽  
Public Health Challenge ◽  
Specific Disorders

Brain health as expressed in our mental health and occurrence of specific disorders such as dementia and stroke is vitally important to quality of life, functional independence, and risk of institutionalization. Maintaining brain health is, therefore, a societal imperative, and public health challenge, from prevention of acquisition of brain disorders, through protection and risk reduction to supporting those with such disorders through effective societal and system approaches. To identify possible mechanisms that explain the differential effect of potentially modifiable risk factors, and factors that may mitigate risk, a life course approach is needed. This is key to understanding how poor health can accumulate from the earliest life stages. It also allows us to integrate and investigate key material, behavioral, and psychological factors that generate health inequalities within and across communities and societies. This review provides a narrative on how brain health is intimately linked to wider health determinants, thus importance for clinicians and societies alike. There is compelling evidence accumulated from research over decades that socioeconomic status, higher education, and healthy lifestyle extend life and compress major morbidities into later life. Brain health is part of this, but collective action has been limited, partly because of the separation of disciplines and focus on highly reductionist approaches in that clinicians and associated research have focused more on mitigation and early detection of specific diseases. However, clinicians could be part of the drive for better brain health for all society to support life courses that have more protection and less risk. There is evidence of change in such risks for conditions such as stroke and dementia across generations. The evidence points to the importance of starting with parental health and life course inequalities as a central focus.

Decomposing the effects of childhood adversity on later-life depression among Europeans: a comparative analysis by gender

2019 ◽  
Vol 41 (1) ◽  
pp. 158-186 ◽  
Author(s):  
Georgia Verropoulou ◽  
Eleni Serafetinidou ◽  
Cleon Tsimbos
Keyword(s):  
Cognitive Function ◽  
Indirect Effects ◽  
Early Life ◽  
Childhood Adversity ◽  
Later Life ◽  
Direct And Indirect Effects ◽  
Excessive Alcohol Consumption ◽  
Childhood Health ◽  
Decomposition Approach ◽  
Adverse Experiences

AbstractThe aims of the present study are twofold: first, to examine the importance of socio-economic disadvantage, adverse experiences and poor health in childhood on later-life depression by sex and, second, to discern the direct and indirect effects of childhood circumstances using a decomposition technique. Data are derived from Waves 2 and 3 of the Survey of Health, Ageing and Retirement in Europe (SHARE). The methods involve use of logistic regression models and a decomposition approach. The findings indicate that childhood socio-economic status (SES) for both genders and cognitive function for men have only a significant direct effect, consistent with the critical period model. Childhood health for men and poor parental mental health for women are nearly fully mediated by adulthood and later-life circumstances, a fact in line with the pathway model. Poor childhood health, parental excessive alcohol consumption and cognitive function for women and adverse experiences for men have both significant direct and indirect effects, consistent with both models. Mediating factors include poor adulthood and later-life health, socio-economic adversity and stress; adulthood and later-life SES mediate early life health and adverse experiences more strongly for men, whereas stress seems to mediate early life adverse experiences to a greater extent among women. Intervening policies should address childhood adversity while considering the differential vulnerability of men and women.

scholarly journals Early-life Socio-economic Status and Adult Health: The Role of Positive Affect

2016 ◽  
Vol 33 (3) ◽  
pp. 190-198
Author(s):  
Kyle W. Murdock ◽  
Angie S. LeRoy ◽  
Christopher P. Fagundes
Keyword(s):  
Positive Affect ◽  
Early Life ◽  
Economic Status ◽  
Adult Health ◽  
Socio Economic Status

scholarly journals Personality and Other Lifelong Influences on Older–Age Health and Wellbeing: Preliminary Findings in Two Scottish Samples

2016 ◽  
Vol 30 (5) ◽  
pp. 438-455 ◽  
Author(s):  
Mathew A. Harris ◽  
Caroline E. Brett ◽  
John M. Starr ◽  
Ian J. Deary ◽  
Wendy Johnson
Keyword(s):  
Social Class ◽  
Personality Traits ◽  
Cognitive Ability ◽  
Early Life ◽  
Structural Equation ◽  
Subjective Wellbeing ◽  
Later Life ◽  
Older Age ◽  
Health And Wellbeing ◽  
Early Life Factors

Recent observations that personality traits are related to later–life health and wellbeing have inspired considerable interest in exploring the mechanisms involved. Other factors, such as cognitive ability and education, also show longitudinal influences on health and wellbeing, but it is not yet clear how all these early–life factors together contribute to later–life health and wellbeing. In this preliminary study, we assessed hypothesised relations among these variables across the life course, using structural equation modelling in a sample assessed on dependability (a personality trait related to conscientiousness) in childhood, cognitive ability and social class in childhood and older age, education, and health and subjective wellbeing in older age. Our models indicated that both health and subjective wellbeing in older age were influenced by childhood IQ and social class, via education. Some older–age personality traits mediated the effects of early–life variables, on subjective wellbeing in particular, but childhood dependability did not show significant associations. Our results therefore did not provide evidence that childhood dependability promotes older–age health and wellbeing, but did highlight the importance of other early–life factors, particularly characteristics that contribute to educational attainment. Further, personality in later life may mediate the effects of early–life factors on health and subjective wellbeing. © 2016 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology

scholarly journals A Longitudinal Study of Allostatic Load in Later Life: The Role of Sex, Birth Cohorts, and Risk Accumulation

2018 ◽  
Vol 41 (5) ◽  
pp. 419-442 ◽  
Author(s):  
Ioana van Deurzen ◽  
Bram Vanhoutte
Keyword(s):  
Longitudinal Study ◽  
Life Course ◽  
Allostatic Load ◽  
Later Life ◽  
The Body ◽  
Life Course Perspective ◽  
Birth Cohorts ◽  
Wear And Tear ◽  
The Life Course

Are challenging life courses associated with more wear and tear on the biological level? This study investigates this question from a life-course perspective by examining the influence of life-course risk accumulation on allostatic load (AL), considering the role of sex and birth cohorts. Using biomarker data collected over three waves (2004, 2008, and 2012) of the English Longitudinal Study of Ageing ( N = 3,824) in a growth curve framework, AL trajectories over a period of 8 years are investigated. Our results illustrate that AL increases substantially in later life. Men have higher AL than women, but increases are similar for both sexes. Older cohorts have both higher levels and a steeper increase of AL over time. Higher risk accumulation over the life course goes hand in hand with higher AL levels and steeper trajectories, contributing to the body of evidence on cumulative (dis)advantage processes in later life.

Sign in / Sign up

Export Citation Format

Share Document