Adult Socioeconomic Position Research Articles

Associations of childhood socioeconomic position and health with trajectories of grip strength from middle to older ages in populations from China and from England

BackgroundWe investigated associations of childhood socioeconomic position and health with trajectories of grip strength from middle to older ages in two distinct populations. MethodsWe used data from the China Health and Retirement Longitudinal Study (CHARLS, n = 16,701) and English Longitudinal Study of Ageing (ELSA, n = 12,695). Hand grip strength was measured at three timepoints in CHARLS (2011–2015) and four in ELSA (2001−2020). Random-effects growth models were applied to assess associations between each childhood factor and age trajectories of grip strength. FindingsLower parental education was associated with weaker grip strength, by 0·36 kg(95 % CI:0·17,0·56) for participants of illiterate (vs literate) parents in CHARLS and 1·88 kg(0·43,3·33) for participants of parents without education (vs ≥ high school) in ELSA, after adjusting for parental occupation and own adult socioeconomic position. Low parental occupation was associated with weaker grip strength, although the difference diminished after adjustment for adult socioeconomic position. Financial hardship was associated with weaker grip strength only in CHARLS, by 0·19 kg(0·01,0·38) after adjustment. Self-rated poor childhood health and school absenteeism were associated with weaker grip strength (both studies). Being confined to bed and hospitalised for more than a month due to health were associated with weaker grip strength only in CHARLS. Each additional childhood illness (only reported in ELSA) was associated with 0·52 kg(0·28,0·81) lower mean grip strength. Reported poor childhood health (CHARLS), low parental education and school absenteeism (ELSA) were associated with grip strength decline. InterpretationLower socioeconomic position and poor health in childhood were associated with weaker grip strength in later life in both Chinese and English populations. Addressing socioeconomic disparities and promoting health of children may enhance life-course physical capacity, promote healthy ageing and reduce age-related adversities.

Childhood socioeconomic differences in type 2 diabetes: longitudinal results of The Maastricht study

Abstract Background Type 2 diabetes mellitus (T2DM) is a common chronic disease that disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have an increased risk of developing T2DM. Knowing the potential influence of early life on T2DM risk later in life, this study aims to examine longitudinal associations between childhood SEP and type 2 diabetes, independent of adult SEP. Methods Longitudinal data was used from 6,727 participants of The Maastricht Study without T2DM at baseline (participants with prediabetes were included in the study sample). T2DM status was determined by a standardized oral glucose test. Sample mean (SD) age was 58.7 (8.7) years and 55.2% was female. Childhood SEP was determined by the highest level of completed education for father and mother and a measurement for childhood income inadequacy. Adult SEP was determined by the highest completed level of education, equivalent household income and occupational position. Incident T2DM was self-reported yearly. Associations were studied annually over a 12-year period (median (IQR) 8.2 (4.9) years) with Cox regression analyses. Results A total of 247 participants (3.7%) without T2DM at baseline reported incident T2DM. Incident T2DM was more common in people with low childhood SEP versus high childhood SEP (4.5% vs. 2.7%, p = 0.008) and for people with low adult SEP versus high adult SEP (5.2% vs. 2.1%, p < 0.001). The impact of parental education on incident T2DM is mitigated by adult SEP. Childhood income inadequacy did predict T2DM independently of adult SEP, with a HR of 1.22 (1.01, 1.45). Conclusions Socioeconomic inequalities in childhood and adulthood are both predictive for incident T2DM. Experiencing income inadequacy in childhood increases the risk of developing T2DM in later life, independent of adulthood SEP. More attention is needed for deprivation in childhood and its impact on T2DM. Key messages • People who have experienced income inadequacy as a child have a higher risk of developing T2DM in later life, independent of their adult SEP. • More attention and research is needed for the impact of childhood poverty on developing T2DM in later life.

Self-rated health in late adolescence as a predictor for mortality between 46 and 70 years of age

Self-rated health is a common assessment used in epidemiological research and an independent predictor of morbidity and mortality. We investigate if a single measure of self-rated health in late adolescence predict mortality between 46 and 70 years of age. This study was based on 47 286 Swedish men that conscribed 1969–1970 at age 18–20 and that were still alive in 1997. Self-rated health and data on potential explanatory factors (psychological factors, health status markers and health behaviors) were collected at conscription. Adult socioeconomic position in 1990 was derived from registries. Death and cause of death (cancer, cardiovascular disease, violent and alcohol abuse related disorders) were derived from the Causes of Death Register between 1997 and 2019. Conscripts that rated their health as fair or poor/very poor had significantly higher hazard of all-cause mortality than conscript that rated their health as very good (HRfair = 1.27, 95%CI:1.18–1.37 and HRpoor = 1.25, 95%CI:1.11–1.41) and disease-specific mortality. Adjusting for all explanatory factors attenuated the risk estimates by 9–100%. In conclusion, poor self-rated health reported in late adolescence predicts all-cause and disease-specific mortality between the ages of 46 and 70 years. Psychological factors and health behaviors measured at conscription may serve as potential explanatory factors underlying the predictive ability of self-rated health in late adolescence.

Adult Socioeconomic Position Mediates the Association between Childhood Socioeconomic Position and Later-Life Frailty Trajectory: A Nationally Representative Cohort Study

Abstract Background and Objectives Early life risk factors influence the aging process in the short term and shape its trajectory in the long term. We aim to 1) explore the association between childhood socioeconomic position and frailty trajectories and 2) test whether adult socioeconomic position mediates the association between childhood socioeconomic position and frailty trajectories. Research Design and Methods We analysed four waves of the China Health and Retirement Longitudinal Study data. The frailty index was estimated based on the number of individual deficits across 40 indicator variables. Principal component analysis was used to generate childhood socioeconomic position and adult socioeconomic position. Group-based trajectory models were used to identify the patterns of frailty trajectories over time. Causal mediation analysis was conducted to determine whether the adult socioeconomic position mediated the association between childhood socioeconomic position and frailty trajectories. Results We identified three distinct trajectories of frailty progression. Low childhood socioeconomic position was significantly associated with “High and increasing frailty trajectory” (OR = 1.76, 95%CI 1.38-2.23; adjusted OR = 1.55, 95%CI 1.22-1.97). About 30% of the childhood socioeconomic position effect on rising frailty trajectory was mediated through the adult socioeconomic position, and there is a significant gender disparity in the mediating effect of adult socioeconomic position (18% among men and 51% among women, respectively). Discussion and Implications Our findings suggest that policies that initially benefit children will yield well-being benefits as they reach adulthood. Promoting ongoing childhood socioeconomic position advantages increases the likelihood of delaying frailty progression in later life. This study underscores the critical importance of addressing social determinants of health throughout one's life course to foster healthy aging and diminish health disparities in later stages of life.

Early adulthood socioeconomic trajectories contribute to inequalities in adult diet quality, independent of childhood and adulthood socioeconomic position

BackgroundDiet is an important risk factor for cardiovascular disease and shows well-established socioeconomic patterning among adults. However, less clear is how socioeconomic inequalities in diet develop across the life course....

Early life socioeconomic inequalities and type 2 diabetes incidence: Longitudinal analyses in the Maastricht study

AimType 2 diabetes (T2D) is a common chronic disease that disproportionally affects groups with a low socioeconomic position (SEP). This study aimed to examine associations between childhood SEP and incident T2D, independent of adult SEP. MethodsLongitudinal data from The Maastricht Study were used (N=6,727, 55.2 % female, mean (SD) age 58.7(8.7) years). Childhood SEP was determined by asking for the highest completed educational level for the father and mother and childhood income inadequacy. Adult SEP was determined by highest completed educational level, equivalent household income, and occupational position. Incident T2D was self-reported yearly (up to 12 years of follow-up). Associations were studied with Cox regression analyses. ResultsIn participants without T2D at baseline, 3.7% reported incident T2D over 8.2 (median) years of follow-up. Incident T2D was most common in people with low childhood and adult SEP and lowest in those with high childhood and adult SEP (1.7 vs. 7.5 per 1,000 person years). The association between childhood SEP and incident T2D was mainly explained by adult SEP, except for childhood income inadequacy which was independently associated with incident T2D. ConclusionSocioeconomic inequalities in childhood and adulthood are risk factors for incident T2D. More attention is needed to reduce childhood poverty and improve adult SEP to reduce the T2D risk.

LifeCourse Socioeconomic Position and Ideal Cardiovascular Health in Hispanic/Latino Adults of the Hispanic Community Health Study/Study of Latinos.

The Hispanic/Latino population experiences socioeconomic disadvantages across the lifespan. Yet, little is known about the role of these disadvantages in cardiovascular health (CVH). We assessed the association of lifecourse socioeconomic position (SEP) with ideal CVH and change in Hispanic/Latino adults. We used longitudinal data from the HCHS/SOL (Hispanic Community Health Study/Study of Latinos). Childhood SEP was determined using parental educational attainment. Adult SEP was determined through an index combining participants' education, occupation, income, and assets at baseline. We classified participants into 4 socioeconomic mobility categories (eg, stable low or high SEP, upward or downward mobility). Using the 4 health factors of the American Heart Association "Life's Essential 8," we built a score of ideal CVH at baseline and the 6-year follow-up. Linear mixed-effects models using inverse probability weighting were fitted to assess the main associations. Higher childhood SEP was associated with higher ideal CVH at baseline (β for high school versus <high school, 3.57 [95% CI, 1.76-5.57]) and (>high school versus <high school, 3.76 [95% CI, 1.99-5.52]). Middle (β for middle versus low SEP, 3.57 [95% CI, 1.65-5.49]) and high adult SEP (β for high versus low SEP, 5.05 [95% CI, 2.55-7.55]) were also associated with higher ideal CVH. Socioeconomic mobility was also associated with higher ideal CVH. No life-course SEP exposure was associated with the change in ideal CVH over a 6-year period. Although high childhood and adult SEP and socioeconomic mobility were associated with higher levels of ideal CVH, they were not associated with change in ideal-CVH.

Intergenerational transmission of health inequalities: towards a life course approach to socioeconomic inequalities in health – a review

Adult health inequalities are a persistent public health problem. Explanations are usually sought in behaviours and environments in adulthood, despite evidence on the importance of early life conditions for life...

Adult offspring's education and parental mortality: A nationwide cohort study of the mediating role of lifestyle-related diseases.

Aim: The mechanisms behind the association between adult offspring's socioeconomic position and their parents' mortality are not well understood. This study investigates lifestyle-related diseases as a potential mediating pathway between adult offspring's education and parental mortality. Methods: This nationwide register-based cohort study consists of 963,742 older adults aged 65 years between 2000 and 2018. Lifestyle-related diseases were measured between 60 and 65 years and those with prior lifestyle-related diseases were excluded. Natural Effect Models were performed to assess potential mediation through lifestyle-related diseases of the association between offspring's education and parental mortality measured by additive hazard estimates with 95% confidence intervals (CIs). Results: Between 60 and 65 years, 150,501 (15.6%) older adults were diagnosed with lifestyle-related diseases and 149,647 (15.5%) died during follow-up. Compared with having offspring with long education, short education was associated with 631 (95% CI: 555; 707) and 581 (95% CI: 525; 638) additional deaths per 100,000 person-years for women and men, respectively, of which 15.4% (95% CI: 9.0; 21.6) and 16.8% (95% CI: 14.6; 18.9) were mediated by lifestyle-related diseases. The corresponding numbers for medium education were 276 (95% CI: 205; 347) and 299 (95% CI: 255; 343) with 26.2% (95% CI: 12.0; 40.6) and 27.6% (95% CI: 25.1; 31.8) mediated by lifestyle-related diseases. Conclusions: Lifestyle-related diseases accounted for 15-28% of the association between offspring's education and parental mortality for both men and women.

Impact of childhood and adult socioeconomic position on change in functional aging.

To examine life-course models by investigating the roles of childhood and adult socioeconomic position (SEP) in longitudinal changes in a functional aging index. Up to eight waves of testing, covering 25 years, were available from the Swedish Adoption/Twin Study of Aging: N = 654, intake age = 50-82. A two-slope latent growth curve model was applied to the data, and the impact of including childhood and adult SEP as covariates of the intercept (at age 70) and slopes (before and after age 70) was tested. Both childhood and adult SEP contributed to the best-fitting model. Childhood SEP was significantly associated with intercept and Slope 1 (before age 70) of the latent growth curve model (p < .05). Association of adult SEP with Slope 2 (after age 70) trended toward significance (p < .10). There was a significant interaction effect of childhood and adult SEP on the intercept (p < .05). As a result, intercept at age 70 was highest and change after age 70 was fastest for those whose SEP decreased from childhood to adulthood. Both childhood and adult SEP impact change in functional abilities with age, supporting both critical period and social mobility models. The social environment is modifiable by policies at local, national, and international levels, and these policies need to recognize that early social disadvantage can have long-lasting health impacts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association Between Trajectory of Socioeconomic Position and Regional Brain Volumes Related to Dementia: Results From the NEIGE Study.

Low socioeconomic position (SEP) has been linked to an increased risk of dementia. However, little is known about the association between SEP trajectory and regional brain volumes related to dementia. A random sample of community-dwelling older adults (n = 428, age = 73.1±5.5) living in Tokamachi City (Niigata Prefecture, Japan) without medical histories of dementia, Parkinson's disease, and depression who underwent automated assessment of brain volumes on magnetic resonance imaging and responded to a self-administered questionnaire survey in 2017. We measured SEP in childhood (household SEP at age 15), young adulthood (education), mid-adulthood (the longest occupation), and late adulthood (current wealth), and further performed group-based trajectory analysis to identify lifetime trajectory patterns on SEP. Multivariate regression models were employed to investigate the association between SEP trajectories and 4 regional brain volumes related to the development of Alzheimer's disease (ie, entorhinal cortex, hippocampus, amygdala, and the parahippocampus), the most common type of dementia. We found 3 distinct SEP trajectories (stable middle class [68%], downward [23%], and upward [9%]). Compared to those who experienced stable middle class, older adults who experienced the upward SEP mobility had significantly larger hippocampus (β: 213.2, 95% confidence interval: 14.7, 411.8). On the other hand, older adults who experienced downward SEP mobility showed no significant differences in any of the 4 brain structural volumes. Our findings indicate that upward life-course SEP mobility is associated with larger volumes of hippocampus in old age. SEP trajectory may offer us a useful lens to enhance our understanding of the etiology of dementia.

Early life socioeconomic position contributes to adult obesity independent of adult socioeconomic factors: Findings from The Sister Study cohort

Low socioeconomic position (SEP) has been associated with obesity within life stages; however, life course SEP may also alter downstream obesity risk. Research is needed to understand the impact of childhood SEP, independent of adult SEP, as well as SEP trajectories over the life course on adult obesity risk. We use data from the Sister Study, a prospective U.S. cohort of women aged 35–74 years (N = 50,884; enrollment: 2003–2009). Relative risks (RR) for adult obesity associated with childhood SEP (latent variable) and five latent life course SEP profiles were estimated in overall and race and ethnicity-stratified log binomial regression models. We estimated the direct effect of childhood SEP on adult obesity and mediation by adult SEP. Lower childhood SEP was associated with greater obesity risk (RR = 1.16, 95% CI: 1.15–1.17). In stratified models, RRs were elevated across groups though lower for Black and Hispanic/Latina participants, despite greater prevalence of obesity among Black participants. The direct effect of childhood SEP on adult obesity persisted in mediation models independent of adult SEP (RR = 1.10, 95% CI: 1.08–1.12) with adult SEP mediating approximately 40% of the total effect of childhood SEP on adult obesity. Furthermore, adult obesity risk was elevated for all life course SEP profiles compared to persistent high advantage. Life course SEP profiles indicating greater advantage in adulthood than childhood were not associated with reduced adult obesity risk among those experiencing less than high advantage in childhood. In conclusion, lower childhood SEP, independent of adult SEP, may be an important risk factor for adult obesity.

Early life factors and grip strength at older ages in two distinct populations in China and England

Abstract Background Early life factors are associated with poor physical and mental outcomes in late life. However how these are associated with grip strength, an objective measure of physical capacity and therefore morbidity and mortality in late life unclear. This analysis therefor explores the long-term effects of adverse childhood socioeconomic experiences and health on grip strength in late life, and how these are mediated by adult factors. Methods Data on early life events, health and socioeconomic factors and grip strength were collected from the China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA). Participants’ first entry into the survey from waves 1-3 in CHARLS and waves 1-9 in ELSA were included in the analysis. Sex stratified linear regression models were used to explore how early life factors affect grip strength. Childhood events included parental socioeconomic position and childhood health. Results 17,205 participants from CHARLS and 6,692 participants from ELSA were included in this analysis. Unlike ELSA, participants from CHARLS were younger, had lower education, low-income occupation and obese. Low parental education and poor child health perception were negatively associated with grip strength even after controlling for childhood and adult factors (adult socioeconomic position, adult body size, adult health and lifestyle) in men from both studies. While parental occupation was associated with grip strength for both males and females in both studies. Association of SEP and health in childhood with grip strengths at older ages were however explained by body size and adult health factors, and not adult SEP. Key messages • Early life socioeconomic position has a persistent effect of late physical health, even after considering adult health, socioeconomic position and lifestyle. • Early intervention in socioeconomic inequalities might improve health outcomes across the life course.

Life-course social disparities in body mass index trajectories across adulthood: cohort study evidence from China health and nutrition survey

BackgroundThe social disparities in obesity may originate in early life or in adulthood, and the associations of socioeconomic position (SEP) with obesity could alter over time. It is unclear how lifetime-specific and life-course SEP influence adult obesity development in China.MethodsBased on the China Health and Nutrition Survey (CHNS), three SEP-related indicators, including the father’s occupational position and the participant’s education and occupational position, were obtained. The life-course socioeconomic changes and a cumulative SEP score were established to represent the life-course SEP of the participants in the study. The growth mixture modeling was used to identify BMI trajectories in adulthood. Multinomial logistic regression was adopted to assess the associations between SEP and adult BMI trajectories.ResultsA total of 3,138 participants were included in the study. A positive correlation was found between the paternal occupational position, the participants’ occupational position, education, and obesity in males, whereas an inverse correlation was observed among females. Males who experienced social upward mobility or remained stable high SEP during the follow-up had 2.31 and 2.52-fold risks of progressive obesity compared to those with a stable-low SEP. Among females, stable high SEP in both childhood and adulthood was associated with lower risks of progressive obesity (OR = 0.63, 95% CI: 0.43–0.94). Higher risks of obesity were associated with the life-course cumulative SEP score among males, while the opposite relationship was observed among females.ConclusionsThe associations between life-course SEP and BMI development trajectories differed significantly by gender. Special emphasis should be placed on males experiencing upward and stable high socioeconomic change.

Life-Course Mobility in Socioeconomic Position and High Depressive Symptoms Among Young Black Women: The SELF Study.

Current literature on the association between mobility in socioeconomic position (SEP) and depression demonstrates mixed findings, with variation in the benefits of upward SEP by racial group and ethnic background. No study has examined life-course SEP mobility and depressive symptoms among Black women in the United States. Our cohort included 1,612 Black women enrolled in the Study of Environment, Lifestyle and Fibroids between 2010 and 2012 and followed for 5years. We used data on socioeconomic indicators at childhood and adulthood and used latent class analysis to create a life-course SEP mobility measure (persistently low, downward, upward, and persistently high). Using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D), we assessed high (≥9) versus low depressive symptoms. Multivariable log risk models were used to produce risk ratios (RRs) and 95% confidence intervals (CIs). Of the participants, 37% had high depressive symptoms. Persistently low (RR, 1.56; 95% CI, 1.31-1.86) and downward (RR, 1.36; 95% CI, 1.14-1.63) SEP mobility was associated with high depressive symptoms after adjustment for age, adult social support, and marital status. There was evidence of an effect measure modification by adult social support, with a stronger association among those who reported high adult social support compared with low adult social support. These findings suggest directing mental health resources to people experiencing low SEP at any stage in life, especially those with low SEP in adulthood, to aid in the management of depressive symptoms.

Smoking status trajectories, intergenerational socioeconomic mobility and depression: Preliminary results from 107,734 French adults (18 to 75 years) of the CONSTANCES cohort

IntroductionCigarette smoking prevalence is significantly higher among people with mental health problems than among the general population. Smoking accounts for much of the reduction in life expectancy associated with mental illness, why the high co-occurrence of smoking and mental health illness is a major public health concern. Persons belonging to socioeconomical disadvantaged groups have higher risk of mental health conditions and also higher smoking rates.ObjectivesIn this study we aim to examine smoking trajectories among adult smokers between 2012 and 2020. Furthermore, we aim to investigate differences in smoking trajectories by adult depression by taking into consideration participants intergenerational socioeconomic mobility (ISEM).MethodsAnalyses were based on data from CONSTANCES, a French general population cohort conducted from 2012 to 2020. In total were 107,734 participants included after exclusion of never smokers. Depression was measured by the CES-D scale, and depression was classified with a score ≥16. ISEM is based on childhood (maternal and parental occupational grade) and adult socioeconomic position (SEP), and low ISEM includes those with low SEP as child and adult and high ISEM those with consistent high SEP. Group-based trajectories modelling (GBTM) was used to determine smoking status trajectories. To address the association between ISEM and smoking trajectory class we used multinomial logistic regression with former smokers as reference class adjusted for depression, household income, sex and age.ResultsWe identified five smoking trajectories 1) Former smokers (56.6%), 2) Long-term smokers (26.4%), 3) Intermediate smokers (3.3%), 4) Early quitters (5.0%) and 5) Late quitters (8.7%). Preliminary results from multinomial logistic regression showed that persons with low ISEM had higher odds of depression (OR [95%CI]=1.91 [1.77;2.06]) than those with high ISEM. Participants with low ISEM had higher odds of being long-term smoking than former smokers compared to those with high ISEM (ORa [95%CI]=1.55 [1.43;1.67]). Furthermore, those with low ISEM had lower odds of being in any of the other smoking trajectory groups vs. former smokers compared to those with high ISEM (ORa [95%CI]=0.82 [0.69;0.97]) for intermediate smokers, ORa [95%CI]=0.75 [0.66;0.85]) for early quitters, and ORa [95%CI]=0.78 [0.70;0.87]) for late quitters).ConclusionsPreliminary results showed an association between ISEM and smoking trajectories in our study. Persons with low ISEM are more likely to be long-term smokers. Future analysis should consider the effect of depression as a mediating factor on the association between ISEM and smoking trajectories.Disclosure of InterestNone Declared

Abstract P655: Childhood and Lifecourse Socioeconomic Position and Cardiovascular Health in Hispanic/Latino Adults of the Hispanic Community Health Study/Study of Latinos

Introduction: The Hispanic/Latino population experiences extensive socioeconomic adversity across the lifespan. Yet little is known about the role of lifecourse socioeconomic position (SEP) on cardiovascular health (CVH) in this population. Hypothesis: Childhood and adulthood SEP as well as socioeconomic mobility are associated with changes in CVH over time in Hispanic/Latino adults. Methods: We used longitudinal data (N = 14,604) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based cohort study conducted in four major U.S cities. We determined childhood SEP using participant-reported parental education classified as No schooling; Elementary, middle, or high school; and more than high school (HS). Adulthood SEP was determined through an index with a score ranging from 0 to 9 combining participants’ education, occupation, annual household income, and assets, and classified as low (0), middle (1-4), and high SEP (5-9). Using childhood and adulthood SEP, we classified participants into socioeconomic mobility categories (e.g., persisting low, downward, or upward mobility, etc.). Using the four-health metrics of the American Heart Association “Life’s Essential 8” (i.e., body mass index, non-HDL cholesterol, fasting blood glucose or HbA1c, and blood pressure) we built a score of ideal CVH ranging from 0 to 100. CVH was assessed at baseline and at the 6-year follow-up. Since changes in CVH over time differed by CVH at baseline, we conducted linear mixed effects models stratifying by CVH at baseline, with random intercept and slope, adjusting for age, sex, Hispanic/Latino background, study center, U.S or foreign-born, years in the U.S, as well as baseline health insurance, diet, physical activity, hours of sleep per night, smoking, alcohol consumption, and antihypertensive and cholesterol medication use. Results: 8% of parents did not have any formal education, 11% of the population had low SEP in adulthood, and 37% showed upward socioeconomic mobility. Among those with low (CVH score &lt;50) and moderate to high (CVH score 50-100) baseline CVH, there was no association between childhood SEP and CVH at baseline. However, among those with moderate to high baseline CVH, high childhood SEP was associated with greater CVH over time (Coefficient for &gt;HS: 0.24, 95% CI: 0.00, 0.47). There was no longitudinal association among those with low baseline CVH. High adulthood SEP was associated with greater CVH at baseline for those with low (Coefficient: 2.55 95% CI: 1.25, 3.85) and moderate to high CVH (Coefficient: 1.36 95% CI: 0.09, 2.62). However, it was not associated with changes in CVH. Socioeconomic mobility was associated with greater baseline CVH as well as with improvements in CVH over time. Conclusion: Among Hispanic/Latino population with high initial CVH, high childhood SEP and socioeconomic mobility were associated with better CVH over time.

Abstract 02: Intergenerational Socioeconomic Mobility is Associated With Adulthood All-Cause Mortality in the Hispanic Community Health Study/Study of Latinos

Introduction: Different patterns of socioeconomic mobility (SEM) across the life course may influence the risk of all-cause mortality in adulthood. Lifetime low socioeconomic status and downward social mobility may be associated with a higher risk of mortality. Hypothesis: SEM is associated with mortality, and persons with enduring intergenerational adversity or downward SEM have a higher risk of mortality compared to persons with enduring intergenerational advantage. Methods: This study included 13,459 participants, 18-74 years of age, from the Hispanic Community Health Study/Study of Latinos who participated in the baseline visit (2008-2011) and were not missing key covariate information. Socioeconomic position (SEP) was assessed as parental education in childhood (dichotomized at high school), and a 5-facet index of SEP in adulthood across education, income, employment status, longest held occupation type, and homeownership. The adulthood SEP index was dichotomized at the median value of 2 (range: 0-5). Childhood and adulthood SEP were then combined into a single 4-level measure of SEM (enduring advantage, upward mobility, downward mobility, and enduring adversity). Multivariable sampling weight-adjusted Cox proportional hazards regression was performed to estimate the association between SEM and all-cause mortality. Potential confounders included age, gender, Hispanic/Latino ethnic background, US nativity, years spent in the US, and study center, whereas alcohol and tobacco use, depression score, and BMI were considered potential mediators. Presence of mediation was assessed by calculating total and direct effects via modeling, then evaluating percent change from total to direct effects against a 10% guideline. Results: During the follow-up period of 2008-2019, 515 deaths were recorded. After adjusting for all potential confounders, a significant association was found between adulthood all-cause mortality and SEM overall (F = 7.62, p &lt; 0.0001). Downward mobility had significantly higher hazard of death compared to enduring advantage (aHR: 1.81, 95% CI: 1.17-2.81), although upward mobility and enduring adversity groups were not significant. The direct effect for downward mobility was reduced after adjustment for potential mediators (aHR: 1.49, 95% CI: 0.96, 2.30). Conclusions: Socioeconomic mobility, specifically downward mobility, is associated with all-cause mortality among a diverse cohort of Hispanic/Latino individuals residing in the United States. This association shows evidence of mediation by clinical and behavioral characteristics.

Examining the Impact of Socioeconomic Position Across the Life Course on Cognitive Function and Brain Structure in Healthy Aging.

This study explores the relationship of life-course intergenerational social mobility with cognitive function and brain structure in older adults using Diagonal Reference Models. Data from the Irish Longitudinal Study on Ageing, a population-based cohort of adults aged 50years and older (N=4620 participants; mean age: 66.1; standard deviation: 9.1; 55% female) was used for analysis. Brain magnetic resonance imaging data were available for 464 participants. Social mobility was characterized as the difference between childhood socioeconomic position (SEP; ie, father's occupation) and adulthood SEP (ie, own occupation). The Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), cortical thickness, and total gray matter volume (GMV) served as global cognitive and brain measures. Exploratory analyses included the volumes of the ventromedial prefrontal cortex (vmPFC), anterior cingulate (AC), hippocampus, and amygdala. Asocial gradient in cognitive function was observed among the intergenerationally stable; brain structure was not as clearly socially patterned. Adulthood SEP was significantly associated with MoCA (weight=0.76; p < .001), MMSE (weight=0.91; p < .001), GMV (weight=0.77; p=.002), and AC volume (weight=0.76; p < .001), whereas childhood SEP was associated with vmPFC volume (weight=1.00; p=.003). There was no independent association of social mobility with any of the outcomes. Together our results suggest that both childhood and adulthood SEP are important in shaping later-life brain health, but that adulthood SEP predominates in terms of its influence. This is potentially an important insight as it suggests that brain health may be modifiable if socioeconomic circumstances change.

Area disadvantage and mental health over the life course: a 69-year prospective birth cohort study

PurposeExisting evidence on the mental health consequences of disadvantaged areas uses cross-sectional or longitudinal studies with short observation periods. The objective of this research was to investigate this association over a 69-year period.MethodsData were obtained from the MRC National Survey of Health and Development (NSHD; the British 1946 birth cohort), which consisted of 2125 participants at 69 years. We assessed longitudinal associations between area disadvantage and mental health symptoms at adolescence and adulthood with use of multilevel modelling framework.ResultsAfter adjustment for father’s social class, for each one percentage increase in area disadvantage at age 4, there was a 0.02 (95% CI 0.001, 0.04) mean increase in the total score of the neuroticism scale at age 13–15. After adjustment for father’s social class, adult socio-economic position, cognitive ability and educational attainment, a one percentage increase in change score of area disadvantage between age 4 and 26 was associated with a mean increase in the total Psychiatric Symptom Frequency score (MD 0.06; 95% CI 0.007, 0.11). Similar associations were observed with change scores between ages 4, 53, 60 and total General Health Questionnaire-28 score at age 53 (MD 0.05; 95% CI 0.01, 0.11) and 60–64 (MD 0.06; 95% CI 0.009, 0.11).ConclusionsCohort members who experienced increasing area disadvantage from childhood were at increased risk of poor mental health over the life course. Population-wide interventions aiming at improving social and physical aspects of the early neighbourhood environment could reduce the socio-economic burden of poor mental health.