Childhood and adult socioeconomic position interact to predict health in mid life in a cohort of British women.

Daniel Nettle,Melissa Bateson

doi:10.7717/peerj.3528

Abstract

BackgroundLow childhood socioeconomic position (cSEP) is associated with poorer adult health, even after adult socioeconomic position (aSEP) is adjusted for. However, whether cSEP and aSEP combine additively or non-additively in predicting adult health is less well studied. Some evidence suggests that the combination of low cSEP and low aSEP is associated with worse health than would be predicted from the sum of their individual effects.MethodsUsing data from female members of the British National Child Development Study cohort, we developed continuous quantitative measures of aSEP and cSEP, and used these to predict self-rated health at ages 23, 33, and 42.ResultsLower aSEP predicted poorer heath at all ages. Lower cSEP predicted poorer health at all ages, even after adjustment for aSEP, but the direct effects of cSEP were substantially weaker than those of aSEP. At age 23, the effects of cSEP and aSEP were additive. At ages 33 and 42, cSEP and aSEP interacted, such that the effects of low aSEP on health were more negative if cSEP had also been low.ConclusionsAs women age, aSEP and cSEP may affect their health interactively. High cSEP, by providing a good start in life, may be partially protective against later negative impacts of low aSEP. We relate this to the extended ‘silver spoon’ principle recently documented in a non-human species.

Highlights

At age 23, the additive model 4 had a lower AICc and was given higher weight than the interactive model 5, whereas at 33 and 42, the interactive model 5 had lower AICc and higher weight. This suggests that both adult socioeconomic position (aSEP) and childhood socioeconomic position (cSEP) are important for predicting health, that their effects are approximately additive at 23, but there is an interaction between them that has emerged by age 33
Continuous standardised measures of aSEP and cSEP for a cohort of British women, we were able to examine their relative predictive power for health in adulthood, and determine whether they interacted. We found that both aSEP and cSEP were related to health
We showed that by ages 33 and 42, they interacted, such that low cSEP makes the negative effects of low aSEP on health stronger

Summary

Introduction

Evidence has accumulated that lower childhood socioeconomic position (cSEP) is associated with poorer health many years later in adulthood (Elo & Preston, 1992; Galobardes, Lynch & Smith, 2004; Pollitt, Rose & Kaufman, 2005; Pollitt et al, 2007; Cohen et al, 2010; Zimmer, Hanson & Smith, 2016) This could be because low cSEP leads to low adult socioeconomic position (aSEP), with low aSEP having direct negative effects on health (Marmot et al, 2001). We relate this to the extended ‘silver spoon’ principle recently documented in a non-human species

Methods

Results

Conclusion