CHILDHOOD SOCIOECONOMIC STATUS AND ADULT ISCHEMIC HEART DISEASE: A LIFE COURSE PATHWAY MODEL OF HEALTH

Abstract

There is a well-established relationship between childhood socioeconomic status (SES) and adult health, but how early-life conditions are able to influence health and aging in later-life is less clear. To elucidate this process, this study investigated how childhood SES influences ischemic heart disease (IHD)—a common disease among older adults—through multiple paths of adult health lifestyles, SES, and chronic inflammation. Guided by two interdisciplinary life course perspectives, this study hypothesized that socioeconomic disadvantage during childhood would lead to unhealthy lifestyles and lower SES in adulthood, which would lead to chronic inflammation that would subsequently raise the risk of IHD. Data came from six waves of the Health and Retirement Study between 2004 and 2014, comprising a sample of 11,697 U.S. men and women aged 51 and older. A series of Cox proportional hazards models examined the relationship between childhood SES and adult IHD. Statistical tests of mediation were conducted to determine whether adult health lifestyles, SES, and chronic inflammation mediated the relationship between childhood SES and adult IHD. Findings revealed that lower childhood SES raised IHD risk by directly impacting adult health lifestyles and SES, which subsequently led to higher levels of systemic inflammation, resulting in onset of IHD. These findings clarify how childhood SES impacts health among older adults. Using multiple mediating domains to assess the long-term effects of early-life conditions can enhance U.S. health policy in an effort to reduce the associated disease burden of childhood SES.