Childhood Social Circumstances Research Articles

Social gradients in ADHD by household income and maternal education exposure during early childhood: Findings from birth cohort studies across six countries

ObjectiveThis study aimed to examine social gradients in ADHD during late childhood (age 9–11 years) using absolute and relative relationships with socioeconomic status exposure (household income, maternal education) during early childhood (<5 years) in seven cohorts from six industrialised countries (UK, Australia, Canada, The Netherlands, USA, Sweden).MethodsSecondary analyses were conducted for each birth cohort. Risk ratios, pooled risk estimates, and absolute inequality, measured by the Slope Index of Inequality (SII), were estimated to quantify social gradients in ADHD during late childhood by household income and maternal education measured during early childhood. Estimates were adjusted for child sex, mother age at birth, mother ethnicity, and multiple births.FindingsAll cohorts demonstrated social gradients by household income and maternal education in early childhood, except for maternal education in Quebec. Pooled risk estimates, relating to 44,925 children, yielded expected gradients (income: low 1.83(CI 1.38,2.41), middle 1.42(1.13,1.79), high (reference); maternal education: low 2.13(1.39,3.25), middle 1.42(1.13,1.79)). Estimates of absolute inequality using SII showed that the largest differences in ADHD prevalence between the highest and lowest levels of maternal education were observed in Australia (4% lower) and Sweden (3% lower); for household income, the largest differences were observed in Quebec (6% lower) and Canada (all provinces: 5% lower).ConclusionFindings indicate that children in families with high household income or maternal education are less likely to have ADHD at age 9–11. Absolute inequality, in combination with relative inequality, provides a more complete account of the socioeconomic status and ADHD relationship in different high-income countries. While the study design precludes causal inference, the linear relation between early childhood social circumstances and later ADHD suggests a potential role for policies that promote high levels of education, especially among women, and adequate levels of household income over children’s early years in reducing risk of later ADHD.

Non-parental care in childhood and health up to 30 years later: ONS Longitudinal Study 1971-2011.

Children who spend time in non-parental care report worse health later in life on average, but less is known about differences by type of care. We examined whether self-rated health of adults who had been in non-parental care up to 30 years later varied by type of care. We used longitudinal data from the office for National Statistics Longitudinal Study. Participants were aged <18 and never-married at baseline of each census year from 1971 to 2001. Separately for each follow-up period (10, 20 and 30 years later), multi-level logistic regression was used to compare self-rated health outcomes by different care types. For combined census years, sample sizes were 157 896 dependent children with 10 years of follow-up, 166 844 with 20 years of follow-up and 173 801 with 30 years of follow-up. For all follow-up cohorts, longitudinal study members who had been in care in childhood, had higher odds of rating their health as 'not good' vs. 'good'; with highest odds for residential care. For example, 10-year follow-up odds ratios were 3.5 (95% confidence interval: 2.2-5.6) for residential care, 2.1 (1.7-2.5) for relative households and 2.6 (2.1-3.3) for non-relative households, compared with parental households after adjustment for childhood demographics. Associations were weakest for 10-year, and strongest for 20-year, follow-up. Additional adjustment for childhood social circumstances reduced, but did not eliminate, associations. Decades after children and young people are placed in care, they are still more likely to report worse health than children who grew up in a parental household.

Shared social mechanisms underlying the risk of nine cancers: A life course study.

Identifying life periods during which social conditions have the highest impact on risk of common cancers in a population may help to reveal their underlying shared social mechanisms. We used the life course framework to estimate the extent to which life course SEP is associated with risk of nine cancers. In addition, we tested whether these associations conform to a critical period or cumulative life course model. Data were from a population-based case-control study of occupational exposures and cancer conducted in Montreal, Canada. Participants were males aged 35-70 years (n = 2,547) residing in the Montreal metropolitan area with primary, histologically confirmed cancers diagnosed between 1979 and 1985. Population controls (n = 512) were sampled from electoral lists. SEP was measured at three different periods of life based on respondent's report: during childhood, young adulthood and mid-life. We used a structured modeling approach using a series of unconditional logistic regressions to test which models best fit the data. Life course SEP increased the risk of all cancers. SEP in childhood was identified as a critical period for prostate and all gastrointestinal tract cancers except for esophagus cancer. In addition, the accumulation model best explained the data for melanoma and lung squamous cell carcinoma. Our findings suggest that childhood social circumstances are a common risk factor for several cancers among men; our results provide insights into the mechanisms involved in the etiology of nine cancers.

Does Growing Childhood Socioeconomic Inequality Mean Future Inequality in Adult Health?

Over the past half century, American children have experienced increasingly unequal childhoods. The goal of this article is to begin to understand the implications of recent trends in social and economic inequalities among children for the future of inequalities in health among adults. The relative importance of many of the causal pathways linking childhood social and economic circumstances to adult health remains underexplored, and we know even less about how these causal pathways have changed over time. I combine a series of original analyses with reviews of relevant literature in a number of fields to inform a discussion of what growing childhood inequalities might mean for future inequalities in adult health. In the end, I argue that there is good reason to suppose that growing inequalities in children's social and economic circumstances will lead to greater heterogeneity in adults' morbidity and mortality.

Childhood Adversities and Socioeconomic Position as Predictors of Leisure-Time Physical Inactivity in Early Adulthood

Background: Limited knowledge exists on how childhood social, health-related and economic circumstances predict adult physical inactivity. Our aim was a) to examine how various childhood adversities and living conditions predict leisure-time physical inactivity in early adulthood and b) to find out whether these associations are mediated through the respondent’s own education. Methods: Young adults aged 18−29 were used from the Health 2000 Study of the Finnish. The cross-sectional data were based on interviews and questionnaires including retrospective information on childhood circumstances. The analyses were carried out on 68% of the original sample (N = 1894). The outcome measure was leisure-time physical inactivity. Results: Only a few of the 11 childhood adversities were related with physical activity in early adulthood. Having been bullied at school was associated with physical inactivity independently of the other childhood circumstances and the respondent’s own education. Low parental education pre...

Childhood adversities and socioeconomic position as predictors of leisure-time physical inactivity in early adulthood.

Limited knowledge exists on how childhood social, health-related and economic circumstances predict adult physical inactivity. Our aim was a) to examine how various childhood adversities and living conditions predict leisure-time physical inactivity in early adulthood and b) to find out whether these associations are mediated through the respondent's own education. Young adults aged 18-29 were used from the Health 2000 Study of the Finnish. The cross-sectional data were based on interviews and questionnaires including retrospective information on childhood circumstances. The analyses were carried out on 68% of the original sample (N = 1894). The outcome measure was leisure-time physical inactivity. Only a few of the 11 childhood adversities were related with physical activity in early adulthood. Having been bullied at school was associated with physical inactivity independently of the other childhood circumstances and the respondent's own education. Low parental education predicted leisure-time physical inactivity in men and the association was mediated by the respondent's own education. Respondents with only primary or vocational education were more likely to be physically inactive during leisure-time compared with those with secondary or higher education. There is some evidence that few specific childhood adversities, especially bullying at school, have long-lasting effects on physical activity levels.

A community cohort study about childhood social and economic circumstances: racial/ethnic differences and associations with educational attainment and health of older adults

ObjectivesTypical measures of childhood socioeconomic status (SES), such as father's occupation, have limited the ability to elucidate mechanisms by which childhood SES affects adult health. Mechanisms could include schooling experiences...

Low Income/Socio-Economic Status in Early Childhood and Physical Health in Later Childhood/Adolescence: A Systematic Review

To systematically review the literature on the relationship between early childhood low income/socioeconomic status (SES) and physical health in later childhood/adolescence, to identify gaps in the literature and to suggest new avenues for research. A systematic search of electronic databases from their start date to November 2011 was conducted to identify prospective longitudinal studies in industrialized countries with a measure of low income/SES in the first 5 years of life and physical health outcomes in later childhood or adolescence. STROBE criteria were used to assess study quality. Risk estimates were expressed as odds ratios with 95 % confidence intervals where possible. Heterogeneity of studies precluded meta-analysis. Nine studies fulfilled the inclusion criteria. Significant associations of early childhood low income/SES with activity-limiting illness, parent-reported poor health status, acute and recurrent infections, increasing BMI percentile and hospitalization were reported. Results for parent-reported asthma were less consistent: there was a significant association with low income/SES in early childhood in 2 studies but null findings in 3 others. This systematic review of the association of early childhood low income/SES with physical health status in later childhood and adolescence shows that, in contrast to the extensive literature on the impact of poor childhood social circumstances on adult health, the evidence base is limited. The literature points to some associations of early low income/SES with later poor health status, but many key research questions remain unanswered. Implications for further research are considered.

Links between childhood and adult social circumstances and obesity and hypertension in the Mexican population.

This study examines links between early life circumstances and adult socioeconomic status and obesity and hypertension in the adult Mexican population. We use data from the Mexican Family Life Survey (MxFLS) collected in 2002 for people aged 20 or older (N = 14,280). We found that men with low education and women with more education have significantly lower obesity. Women with higher education also have significantly less hypertension. Obesity triples the likelihood of hypertension among both men and women. Better childhood experiences are associated with less hypertension among women, but more hypertension among men in rural areas. Recent changes in income, nutrition, and infection in Mexico may be responsible for the observed high prevalence of overweight and obesity and the extremely high odds of hypertension among obese young adults.

Educational Level and Coronary Heart Disease: A Study of Potential Confounding from Factors in Childhood and Adolescence Based on the Swedish 1969 Conscription Cohort

Previous studies suggest that the risk of coronary heart disease (CHD) may be related to educational level. In the present study, we looked at factors in childhood and adolescence as potential confounders of the relationship between educational level and risk of CHD. We also examined hypothesized mediation by socioeconomic factors in adulthood. The 1969 conscription cohort consisting of 49,321 Swedish men born in 1949 through 1951, who conscripted for military service in 1969/70, provided information on potential confounders. This was linked with register-based information on childhood social circumstances, education level, occupational class, income and job control in adulthood, and follow-up information on CHD during 1991 through 2007. The relative risk of CHD increased with lower educational level. Among men with the lowest educational level, the relative risk of CHD was 1.81 (95% confidence interval, 1.60-2.05) compared with the highest educated group of men. Adjustment for childhood socioeconomic circumstances, and cognitive ability and behavior-related factors measured in late adolescence, attenuated the association considerably. Additional adjustment for socioeconomic position, income, and job control in adulthood did not attenuate the association further. It may be that educational level and risk of CHD are associated importantly owing to confounding from factors in childhood and adolescence.

Childhood social circumstances and body mass index in adult life: The Metropolit 1953 Danish male birth cohort

To examine whether father's social class was associated with body mass index (BMI) at age 20 and 50 years in a cohort of men born in 1953 and to explore the role of birth weight, cognitive function (IQ), and educational status in these relationships. We used data from the Metropolit cohort which includes 11,532 Danish men born in 1953 with information on father's socioeconomic position (SEP) at participant's birth and assessments of height, weight, cognitive performance, and education at age 20. In 2004, 6292 of these men participated in a follow-up survey on health and behaviour. Linear and logistic regression were used to investigate the association of father's social class with BMI among the 5117 men with complete information on all variables. Between age 20 and 50, mean BMI increased from 21.4 to 26.1 kg/m(2), while the prevalence of overweight (BMI ≥25 kg/m(2)) increased from 8.1 to 57.8%. Men of fathers who were skilled or unskilled workers had higher odds of being overweight (OR = 1.32, 95% CI 1.13-1.53) or often obese (OR = 1.28, 95% CI 1.03-1.60) at age 50 years compared to those with fathers being self-employed, employee, or civil servants when adjusted for the other socially correlated indicators of impaired childhood development. In the linear regression analyses, mean BMI at both age 20 and 50 were around 0.3 kg/m(2) higher in men with fathers from working class compared to those self-employed, employee, or civil servants. This study supports that among men, father's SEP influences the development of obesity later in adult life.

Childhood socio-economic position and risk of coronary heart disease in middle age: a study of 49 321 male conscripts

Poor social circumstances in childhood are associated with increased risk of coronary heart disease (CHD). In previous studies, social circumstances and risk factors in adulthood have been suggested to explain this association. In the present study, we included potential explanatory factors from childhood and adolescence. We investigated the association between childhood socio-economic position (SEP) and CHD in middle age among 49,321 Swedish males, born during 1949-51, who were conscripted for military service at 18-20 years of age. Register-based data on childhood social circumstances, educational attainment and occupational class in adulthood were used in combination with information on cognitive ability, smoking, body mass index and body height in late adolescence obtained from a compulsory conscription examination. Incidence of CHD from 1991 to 2007 (between 40 and 58 years of age) was followed in national registers. We demonstrated an inverse association between childhood SEP and CHD in middle age: among men with the lowest childhood SEP the crude hazard ratio of CHD was 1.47 (95% CI = 1.30-1.67). Adjustment for crowded housing in childhood, body height, cognitive ability, smoking and BMI in late adolescence attenuated relative risks of CHD considerably. Additional adjustment for educational level had a further, although limited, attenuating effect on associations, but additional adjustment for occupational class had no such effect. Results showed that social, cognitive and behavioural factors evident prior to adulthood may be of greater importance in explaining the association between childhood SEP and CHD later in life than socio-economic indicators in adulthood.

Do childhood social circumstances affect overweight and obesity in early adulthood?

The aim of the study was to examine the association of childhood circumstances with overweight and obesity in early adulthood, to analyse whether the respondent's education and current circumstances mediate these associations, and to explore whether the respondent's health behaviour affects these associations. This was a cross-sectional study with retrospective inquiries. The study was based on a representative two-stage cluster sample (N= 1894, participation rate 79%) of young adults aged 18-29 years in Finland in 2000. The outcome measure was three-class body mass index (BMI) (normal weight, overweight, and obesity). Multinomial logistic regression was used as the main statistical tool. In women, childhood circumstances (low parental education (relative risk ratio (RRR) = 2.43), parental unemployment (RRR= 2.09) and single-parent family (RRR= 1.99)) increased the risk of overweight (25 < or = BMI<30), but the effects were largely attenuated by other childhood factors and early adult circumstances. In men, no significant childhood predictors of overweight were found. Single-parent family (RRR=2.32), parental alcohol problem (RRR= 2.71), parental mental health problems (RRR=2.28) and being bullied at school (RRR=3.13) predicted obesity (BMI > or = 30) in women in the age-adjusted models, and being bullied at school remained a significant predictor after adjusting for all childhood and current determinants. In both genders, the strong association between parental education and obesity remained significant after adjusting for all other determinants (for the lowest educational category, RRR= 3.56 in women, and RRR= 6.55 in men). Childhood factors predict overweight and obesity in early adulthood. This effect is stronger on obesity than on overweight and in women than in men, and it seems to be partly mediated by adult circumstances. The results emphasize the lasting effect of childhood socioeconomic position on adult obesity. When preventive policies are being planned, social circumstances in childhood should be addressed.

IQ in Early Adulthood and Mortality By Middle Age

High premorbid IQ test scores are related to a reduced rate of later total mortality, although little is known about the shape of this association (ie, dose-response versus threshold), or the role of mediating and confounding factors in explaining it. Additionally, the link between IQ and cause-specific mortality has been little explored.A cohort of over 1 million Swedish men who underwent IQ testing at military service conscription at about 18 years of age was followed for mortality experience until middle age.An average of 20 years of follow-up gave rise to 14,498 deaths in an analytical sample of 994,262. In basic analyses adjusting for age, year of birth, and conscription testing center, lower IQ scores were associated with an elevated risk of all-cause mortality (HRper 1-SD decrease in IQ; 1.32; 95% confidence interval = 1.30-1.34). This relation was incremental across the full IQ range, and was robust to adjustment for indicators of childhood social circumstances. The association did not appear to be mediated by factors measured concurrent with IQ (blood pressure, body mass index, or cigarette smoking), nor was it attributable to reverse causality. However, controlling for education (a close correlate of IQ) led to marked attenuation. IQ was also associated with mortality from accidents, coronary heart disease, and suicides, but not cancer.In this large cohort we found a robust stepwise relation between early adult IQ and risk of total and accident mortality in men.

The influence of birth weight and body mass in early adulthood on early coronary heart disease risk among Danish men born in 1953

This study examines the joint and separate influence of birth weight and body mass in young adulthood on subsequent coronary heart disease (CHD) risk. A cohort of 9,143 men born in Copenhagen, Denmark, in 1953, for whom information on birth weight and body weight and height around age 19 years were retrieved from birth certificates and conscript records, respectively, were followed from 1978 until 2005 (between age 25 and 52 years) for incident fatal and non-fatal CHD. Data on CHD were obtained through record linkage to the Cause of Death Registry and the National Patient Registry. During follow-up, a total of 475 men had a CHD diagnosis. Men with low birth weight, high body mass index (BMI) at age 19, a father from the working class, and low educational level at age 19 had an increased risk for CHD. Birth weight was inversely associated with CHD only in men with BMI of 25 kg/m(2) or above. Adjustment for childhood social circumstances and educational status at age 19 had minor influence on the estimates. In conclusion, BMI in young adulthood seems to be strongly associated with the risk of CHD before age 52, and birth weight seem to modify the association. The risk estimates is highest for individuals with a combination of low birth weight and overweight in young adulthood.

Childhood social circumstances and health behaviour in midlife: the Metropolit 1953 Danish male birth cohort

It has been suggested that the association between social disadvantage in childhood and adult mortality could come about through processes related to the family environment in which the child is raised. This study examines the relationship of fathers' social class with health behaviour in middle age and assesses the potential mediating role of cognitive function, educational status and social integration in young adulthood in these relationships. We used data from the Metropolit cohort which includes 11 532 Danish men born in 1953 with information on fathers' social class at participants' birth and assessments of cognitive performance, education and social integration in early adulthood. In 2004, 6292 of these men participated in a follow-up survey on health and behaviour. Logistic regression was used to investigate the association of father's social class with smoking, alcohol drinking, leisure-time physical activity and the intake of fruit and vegetables in midlife. Middle-aged men with fathers from higher social classes were more often ex-smokers, wine drinkers and daily consumers of fruit or vegetables than men with working class fathers. Leisure activities and high alcohol consumption were not related to father's social class. Cognitive function and educational achievement at age 18 attenuated the association of father's social class with adult behaviour, while indicators of social integration had very little impact on the associations. Father's social class influences adult smoking, alcohol preference and food intake, and a major part of the effect is mediated through cognitive function and education.

Childhood and Current Determinants of Heavy Drinking in Early Adulthood

To explore the association of parental education, childhood living conditions and several adversities with heavy drinking in early adulthood, and to analyze the effect of the respondent's current circumstances on these associations. The analyses were conducted in a sample of 1234 adults aged 18-29 years participating in the Finnish Health 2000 Survey (65% of the original representative two-stage cluster sample, N = 1894). The outcome measure was heavy drinking measured by g/week for pure alcohol (for men >or=280 g/week and for women >or=140 g/week). 8% of young adult men and 5% of women were heavy drinkers. In both genders, parental alcohol problems and other childhood adversities, poor own education, and unemployment status increased the risk of heavy drinking. The impact of childhood on heavy drinking was partly independent and partly mediated by adult characteristics, in particular, for both genders, low level of education. Childhood adversities are associated with heavy drinking in early adulthood among both genders. Childhood social circumstances as well as low educational level and unemployment should be taken into account in planning preventive policies to tackle the harms caused by excessive alcohol use at the individual and population level.

Housing conditions in childhood and cause-specific adult mortality: The effect of sanitary conditions and economic deprivation on 55,761 men in Oslo

To examine indices of two plausible pathways linking housing conditions in childhood and adult cause-specific mortality: sanitary conditions and economic deprivation. To investigate if the effects of these are explained by education. Linked register study (housing information from the 1960 Census, the educational register in 1990 and the death register 1990-998). A Sanitary Conditions Index (SCI) and an Economic Deprivation Index (EDI) were constructed from the housing conditions variables. All men aged 30-54 years (n = 55,761) who were residents in Oslo on 1 January 1990 with complete information on housing conditions (80%). Both SCI and EDI were related to all-cause mortality independently of each other. Education explained to a large extent these effects. In a sub-sample, 24% of the effects could be explained by parental education and 31% by own education. The effects found for causes of death failed to give a heterogeneous pattern between the two indices. In the fully adjusted model psychiatric causes of death appeared to be more related to EDI than SCI. The two indices of childhood social circumstances, sanitary conditions and economic deprivation, appeared to be independently associated with all-cause mortality. The effect of both could to a large extent be explained by parental and own education.

Older adults' perspectives on key domains of childhood social and economic experiences and opportunities: a first step to creating a multidimensional measure

ObjectivesAlthough research has found that childhood socioeconomic status (SES) is associated with physical and mental health in mid- and later life, most of these studies used conventional, single dimension SES measures for the childhood period such as household income or educational attainment of parents. Life course and health disparities research would benefit from identification and measurement of a variety of childhood social and economic experiences and opportunities that might affect health in later life.DesignThis study utilized qualitative research methods to identify key dimensions of childhood experiences related to SES. We conducted in-depth interviews with 25 adults age 55 to 80 years from diverse economic and ethnic backgrounds. Topics included home, neighborhood, school, and work experiences during early childhood and adolescence. Interviews were audio-taped and transcripts were coded to identify thematic domains.ResultsWe identified eight thematic domains, many of which had clear subdomains: home and family circumstances, neighborhood, work and money, potential for advancement through schooling, school quality and content, discrimination, influence and support of adults, and leisure activities. These domains highlight individual characteristics and experiences and also economic and educational opportunities.ConclusionThese domains of childhood social and economic circumstances add breadth and depth to conventional conceptualization of childhood SES. When the domains are translated into a measurement tool, it will allow for the possibility of classifying people along multiple dimensions, such as from a low economic circumstance with high levels of adult support.

Transgenerational response to nutrition, early life circumstances and longevity

Nutrition might induce, at some loci, epigenetic or other changes that could be transmitted to the next generation impacting on health. The slow growth period (SGP) before the prepubertal peak in growth velocity has emerged as a sensitive period where different food availability is followed by different transgenerational response (TGR). The aim of this study is to investigate to what extent the probands own childhood circumstances are in fact the determinants of the findings. In the analysis, data from three random samples, comprising 271 probands and their 1626 parents and grandparents, left after exclusions because of missing data, were utilized. The availability of food during any given year was classified based on regional statistics. The ancestors' SGP was set at the ages of 8-12 years and the availability of food during these years classified as good, intermediate or poor. The probands' childhood circumstances were defined by the father's ownership of land, the number of siblings and order in the sibship, the death of parents and the parents' level of literacy. An earlier finding of a sex-specific influence from the ancestors' nutrition during the SGP, going from the paternal grandmother to the female proband and from the paternal grandfather to the male proband, was confirmed. In addition, a response from father to son emerged when childhood social circumstances of the son were accounted for. Early social circumstances influenced longevity for the male proband. TGRs to ancestors' nutrition prevailed as the main influence on longevity.