The Long Arm of Prospective Childhood Income for Mature Adult Health in the U.S.

Pioneering scholarship links retrospective childhood conditions to mature adult health. We distinctively provide critical evidence with prospective state-of-the-art measures of parent income observed multiple times during childhood in the 1970s-1990s. Using the Panel Study of Income Dynamics, we analyze six health outcomes (self-rated health, heart attack, stroke, life-threatening chronic conditions, non-life-threatening chronic conditions, and psychological distress) among 40-65 year olds (N=3,813-3,944). Parent relative income rank has statistically and substantively significant relationships with five of six outcomes. The relationships with heart attack, stroke and life threatening chronic conditions are particularly strong. Parent income rank performs slightly better than alternative prospective and retrospective measures. At the same time, we provide novel validation on which retrospective measures (i.e. father’s education) perform almost as well as prospective measures. Further, we inform several perennial debates about how relative versus absolute income and other measures of socio-economic status and social class influence health.

Childhood diagnoses in individuals identified as autistics in adulthood

Background Autism is a developmental condition, where symptoms are expected to occur in childhood, but a significant number of individuals are diagnosed with autism for the first time in adulthood. Here, we examine diagnoses given in childhood among individuals that are diagnosed with autism in adulthood, to investigate whether the late autism diagnosis might be explained by misdiagnosis in childhood or diagnostic overshadowing. Methods Through the Danish National Patient Registry, we identified individuals diagnosed with autism in adulthood (N = 2199), as well as a control sample with no records of an autism diagnosis (N = 460,798) and calculated how many had received different psychiatric or neurological diagnoses in childhood. Results We found that most childhood diagnoses were overrepresented in those with an adult autism diagnosis, and attention-deficit hyperactivity disorder, affective disorders, anxiety, and stress disorders were the most prevalent childhood conditions in this group. However, 69% of males and 61% of females with adult autism diagnoses were not found to have received any of the investigated diagnoses before 18 years of age, and most childhood diagnoses were given after the age of 12. Limitations Milder to moderate cases of psychiatric conditions that have been solely treated by family physicians or school psychologists may not be fully included in our dataset. The study is based on data from the Danish health care system, and further research is needed to assess whether the findings can be generalized to other countries. Conclusion A majority of those with an adult autism diagnosis had no records of having received any of the investigated diagnoses in childhood. In these cases, the late autism diagnosis is therefore unlikely to be explained by either misdiagnosis or overshadowing. This result is at odds with the prevailing notion that autistic symptoms tend to diminish with age. Therefore, further research is warranted to examine how and if early signs of autism may have manifested among these individuals, and how similar they are to autistic people diagnosed earlier in their development.

Gender Differences in Avoiding Later-Life Disability: A Life Course Perspective

Identifying the early origins of adult health has underscored how experiences in the earliest stages of life can have lasting consequences. Whereas most research on the early origins of adult health has linked childhood conditions to worse health in adulthood, this study considered whether childhood conditions are associated with healthy aging. Guided by the World Health Organization’s emphasis on functional ability as a core component of healthy aging, the present study investigated the association between childhood social conditions and avoiding later-life limitations in basic and instrumental activities of daily living, referred to as disability-free status. This study also tested potential health-related and socioeconomic mediators and examined whether these life course antecedents of healthy aging vary by gender. Analyzing a sample of 9,376 adults over age 50 from the Health and Retirement Study over 10 years (2006-2016) revealed that childhood socioeconomic disadvantage reduced the odds of avoiding disability over time. For women, adult health lifestyles mediated this relationship whereas adult socioeconomic status (SES) mediated this relationship for men. Conditional indirect effects indicated that the mediational effects of body mass and education differed between men and women (i.e., moderated mediation). The direct effects of childhood and adult SES also varied by gender. These results demonstrate that the life course antecedents, especially SES, of healthy aging are distinct for men and women. Interventions should prioritize reducing early-life exposure to socioeconomic disadvantage, especially for women. Given the gendered differences in the mediating effects, midlife interventions can be tailored for men and women.

Consulting with children

Plastic surgery deals with appearance and function, and a significant proportion of its work is in children with birth or developmental defects who require care throughout childhood and sometimes as an adult. For some plastic surgeons, children form a major part of their work whereas for others, their skills set may only occasionally be relevant to childhood conditions. Consulting with children and their families requires special circumstances and techniques for success. In this chapter (which should be read in conjunction with Chapter 13.2), the theoretical aspects of consulting with children is first examined, before considering the practical consequences for clinic arrangements.

Adolescents with different life problems seeking help before and after the introduction of a low-threshold service model: a Finnish qualitative study

There are several concerns related to adolescents living in families with severe and persistent problems. Childhood conditions may contribute to later social exclusion, for example. The aim of this study was to describe study participants’ service experiences before and after the introduction of a low-threshold service model. This model—based on the reformed Youth Act—was developed and implemented during a 2-year project. Data were collected through interviews of seven adolescents during phase one. In phase two, four adolescents responded to essay questions. The views of a youth worker working for this project were also collected, as she played a key role in helping the adolescents. The adolescents participating in this study were girls aged between 12 and 17. Thematic deductive analysis was performed. Two main themes were evident in the participants’ responses regarding their service experiences: the accessibility and acceptability of services. The model highlights the importance of listening to adolescents related to their various problems. The focus is on preventive services and early support. Coordination of preventive services requires special expertise and joint development in inter-professional practices. Moreover, adolescents’ experiences should be taken into consideration in the development of services.

Childhood hunger experiences and chronic health conditions later in life among Brazilian older adults

Objectives. To assess the association between childhood hunger experiences and the prevalence of chronic diseases later in life. Methods. A cross-sectional study was conducted using baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a nationally representative study of persons aged 50 years and older (n = 9 412). Univariate and bivariate analyses were used to describe the sample, and multivariate logistic regressions to examine the association between childhood hunger and hypertension, diabetes, arthritis and osteoporosis. Adjusted odds ratios and predicted probabilities were calculated. Results. 24.7% of Brazilians aged 50 and over experienced hunger during childhood. This harmful exposure was significantly more common among non-white people, individuals with lower educational attainment, lower household income and heavy manual laborers. Regional variation was also observed, as the prevalence of individuals reporting childhood hunger was higher in the North and Northeast regions. The multivariate analysis revealed that older adults who reported having experienced hunger during childhood had 20% higher odds of developing diabetes in adulthood (aOR = 1.20, 95% CI: 1.02 – 1.41) and 38% higher odds of developing osteoporosis (aOR = 1.38, 95% CI: 1.15 – 1.64) than adults who did not experience hunger during childhood, after controlling for covariates. Conclusions. The study showed an association between childhood hunger and two chronic diseases in later life: diabetes and osteoporosis. This work restates that investing in childhood conditions is a cost-effective way to have a healthy society and provides evidence on relationships that deserve further investigation to elucidate underlying mechanisms.

The association between childhood conditions and heart disease among middle-aged and older population in China: a life course perspective

Background Heart disease is a severe health problem among adult populations in China. The prevalence rates of heart disease increase with age. The pathogenic causes of heart disease are often related to conditions in early life. Using a nationally representative sample of adults aged 45 or older in China, we examined the association between childhood conditions and heart disease in later life from a life course perspective. Methods The data used in this study were derived from the life history module and 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). Missingness were handled by multiple imputation, generating 20 complete datasets with a final sample of 19,800. Doctor-diagnosed heart disease was the main dependent variable. Respondents’ conditions in childhood, adulthood, and older age were the independent variables (e.g., socioeconomic status, health, and health resources). Random-effects logistic regression models were conducted to test the hypotheses. Results A total of 16.6% respondents reported being diagnosed with heart disease by doctors. Regarding childhood socioeconomic status, 8.2% of the respondents considered that they were (a lot) better off than their neighbors, and 31.1% considered that their health status in childhood was better than their peers. More than 90% of respondents did not have severe illnesses during their childhood, and around 80.3% had access to health resources nearby in childhood. Lower socioeconomic status and poorer health conditions in childhood were associated with a greater likelihood of reporting doctor-diagnosed heart diseases, even after controlling for conditions in adulthood and older age (socioeconomic status: odds ratio (OR) = 0.947; self-rated health: OR = 0.917; severe illnesses: OR = 1.196). Conclusions Along with chronic diseases (e.g., hypertension, diabetes, and dyslipidemia), unhealthy behaviors, overweight and obesity, poor childhood conditions should be considered as screening criteria to identify populations at risk of heart disease. Relevant preventive strategies and interventions should be developed from a life course perspective and conducted in communities by providing health education program among older population with low socioeconomic status, and encouraging early detection and treatment.

Perception of Neighborhood Characteristics During Childhood and Cognitive Health Among Older Adults in China

Neighborhood environments shape the availability of resources for social engagement and social interaction, which are associated with better health outcomes. However, these contextual factors are also considered sources of potential social distress and tension, increasing the risk of subsequent health deficits, including cognitive decline. Our understanding of the linkage between childhood neighborhood environments and cognitive functioning in later life is limited. This study employed three waves of nationally representative data from the China Health and Retirement Longitudinal Study (2011-2015; N = 11,105) to investigate the relationship between self-reported neighborhood social cohesion during childhood (i.e., neighborhood safety, neighbors willing to help, and close-knit neighborhood) and cognitive functioning (Chinese version of TICS). We employed latent growth curve modeling to test hypotheses relating to life course models of childhood conditions and later life cognitive functioning (the long arm of childhood). The results showed that perceptions regarding the willingness of neighbors to help and close-knit neighborhood characteristics during childhood were positively associated with levels of later life cognitive function. Further, growing up in a neighborhood characterized by the willingness of neighbors to help others was negatively associated with the rate of cognitive decline, net of childhood and adulthood covariates. Self-report of neighborhood safety during childhood was unrelated to cognitive function (level and change). These findings underscored the long-term ramifications of childhood conditions as potential risk factors for later-life cognitive health. Social cohesion at the neighborhood level as experienced during childhood may be a protective factor for healthy cognitive aging among older Chinese adults.