Abstract
How do early-life conditions affect adult mortality? Research has yielded mixed evidence about the influence of infant and child mortality in birth cohorts on adult health and mortality. Studies rarely consider the specific role of mortality within the family. We estimated how individuals’ exposure to mortality as a child is related to their adult mortality risk between ages 18 and 85 in two historical populations, Utah (USA) 1874–2015 and Zeeland (The Netherlands) 1812–1957. We examined these associations for early community-level exposure to infant and early (before sixth birthday) and late (before eighteenth birthday) childhood mortality as well as exposure during these ages to sibling deaths. We find that that exposure in childhood to community mortality and sibling deaths increases adult mortality rates. Effects of sibling mortality on adult all-cause mortality risk were stronger in Utah, where sibling deaths were less common in relation to Zeeland. Exposure to sibling death due to infection was related to the surviving siblings’ risk of adult mortality due to cardiovascular disease (relative risk: 1.06) and metabolic disease (relative risk: 1.42), primarily diabetes mellitus, a result consistent with an inflammatory immune response mechanism. We conclude that early-life conditions and exposure to mortality in early life, especially within families of origin, contribute to adult mortality.
Highlights
The first birth cohorts which experienced decreasing mortality in childhood were the first to experience an increase in life expectancy in adulthood (Crimmins and Finch 2006), suggesting that health and survival in adulthood may be influencedExtended author information available on the last page of the article1 3 Vol.:(0123456789)by early-life exposure to disease and famine (Barker et al 2002; Bengtsson and Lindström 2000; Finch and Crimmins 2004; Fridlizius 1989)
The hazard of adult mortality as a function of exposure to sibling mortality is estimated based on comparisons to individuals from the same birth cohort
We have examined whether exposure to deaths during childhood may create enduring health effects
Summary
The first birth cohorts which experienced decreasing mortality in childhood were the first to experience an increase in life expectancy in adulthood (Crimmins and Finch 2006), suggesting that health and survival in adulthood may be influenced. Recent research has shown that in modern-day Scandinavia childhood exposure to sibling mortality leads to an increased likelihood of death between birth and age 37 (Yu et al 2017), suggesting that sibling deaths have a lasting influence on health and mortality; it remains unknown whether survival is affected in later adulthood. Alter et al (2001) analyzed sibling mortality to assess the role of health behaviors in explaining excess mortality in early and later life They found that sibling mortality affects mortality among other siblings during childhood but diminishes after age 15 with no effects after age 55, while demonstrating evidence consistent with acquired immunity after age 30. We compare two populations to assess the effect of exposure to mortality in different mortality régimes
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