Early-life Socioeconomic Circumstances Research Articles

Do child mental & physical health explain inequalities in adolescent NEET status? A UK Cohort Study

Abstract Around 1 in 10 young people (YP) (16-24 years) are Not in Education, Employment, or Training (NEET) in the United Kingdom (UK). Socioeconomically disadvantaged YP are more likely to become NEET. Poor physical and mental health and disability are known risk factors for NEET status, yet their potential to mediate the relationship between socioeconomic circumstances (SEC) and NEET status remains unclear. We aimed to quantify which childhood health pathways explain inequalities in adolescent NEET status. We analysed data on 5,786 YP from the Millennium Cohort Study (MCS), a nationally representative sample of the UK population. Early life SEC was measured by highest parental occupational status at birth. NEET status was derived from four questions on education, employment, and training at 17 years. Mediators across childhood were grouped into family health (parental limiting illness, mental and general health, and young carer status) perinatal health (birth weight, smoking during pregnancy, school readiness score), physical health (weight status, asthma, general health, longstanding illness at 11 years), and mental health (mental health score, self-esteem, and ASD/ADHA statement). We used logistic regression to examine the total effect of SEC on adolescent NEET status whilst adjusting for confounders (sex, maternal age, and education), then adjusted for potential mediators. Using causal mediation analysis, we will estimate the proportion mediated by blocks of mediators and the natural indirect effect (NIE) via each block of mediators. After adjustment for confounding, YP whose parents were unemployed were more than 8 times as likely to be NEET at 17 years compared with those whose parents had managerial occupations (Odds Ratio (OR) 8.55, 95% CI 3.73 to 19.64). After adjustment for all childhood health conditions, there was a 34% reduction to aOR 5.99 (95% CI 2.42 to 14.85). Childhood health conditions partially contribute to inequalities in adolescent NEET status. Key messages • Childhood mental and physical health are important for targeting interventions to reduce inequalities in adolescent NEET status. • More than a third of the social inequality in NEET status was explained by perinatal, physical, and mental health during childhood.

Early-life socioeconomic circumstances and the comorbidity of depression and overweight in adolescence and young adulthood: A prospective study

Depression and overweight both often emerge early in life and have been found to be associated, but few studies examine depression-overweight comorbidity and its social patterning early in the life course. Drawing on data from 4,948 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort from the UK (2,798 female, 2,150 male), we investigated how different aspects of early-life socioeconomic circumstances are associated with depression-overweight comorbidity from adolescence to young adulthood exploring any differences by age and sex. We estimated how parental education, social class and financial difficulties reported in pregnancy were associated with depression and overweight, and their comorbidity at approximately the ages 17 and 24 in males and females. The results from multinomial logistic regression models showed that all three socioeconomic markers were associated with depression-overweight comorbidity and results were similar across age. Lower parental education (relative risk ratio (RRR) and 95% confidence interval (CI) of low education v high education: 3.61 (2.30-5.67) in females and 1.54 (1.14-2.07) in males) and social class (class IV/V v class I: 5.67 (2.48-12.94) in females and 3.11 (0.70-13.91) in males) had strong associations with comorbidity at age 17 relative to having neither depression or overweight. Financial difficulties were also a risk factor in females, with less clear results in males. These findings highlight how early socioeconomic circumstances are linked with the accumulation of mental and physical health problems already in adolescence, which has implications for life-long health inequalities.

Early-Life Socioeconomic Circumstances and Physical Activity in Older Age: Women Pay the Price

Health in older age is shaped by early-life socioeconomic circumstances (SECs) and sex. However, whether and why these factors interact is unclear. We examined a cultural explanation of this interaction by distinguishing cultural and material aspects of SECs in the context of physical activity—a major determinant of health. We used data from 56,331 adults between 50 and 96 years old from the Survey of Health, Ageing and Retirement in Europe (SHARE), a 13-year, large-scale, population-based cohort. Confounder-adjusted logistic linear mixed-effects models showed an association between the cultural aspects of early-life SEC disadvantage and physical activity among women, but it was not consistently observed in men. Furthermore, these associations were compensated for only partially by adult-life socioeconomic trajectories. The material aspects of early-life SECs were not associated with adult-life physical activity. These findings highlight the need to distinguish different aspects of SECs because they may relate to health behaviors in diverse ways.

Disadvantage in early-life and persistent asthma in adolescents: a UK cohort study

ObjectiveTo determine how early-life risk factors explain socioeconomic inequalities in persistent asthma in adolescence.MethodsWe did a causal mediation analysis using data from 7487 children and young people in the UK...

Socioeconomic circumstances and lung function growth from early adolescence to early adulthood.

A reduced lung function in early adulthood is associated with respiratory and non-respiratory diseases and is a long-term predictor of mortality. This study investigated the association between early socioeconomic circumstances (SEC) and lung function growth trajectories from early adolescence until early adulthood. We analysed data from the EPITeen population-based study, including adolescents born in 1990. Study waves occurred at 13, 17 and 21 yearsof age. Information on sociodemographic, behavioural and health factors, anthropometry and spirometry was collected. Early-life SEC were assessed using maternal education and paternal occupational position. The forced expiratory volume in the first second (FEV1) growth trajectories were drawn considering sex-and-height interactions over an 8-year period. Our sample included 2022 participants with complete informationfor the relevant variables. Participants from most disadvantaged SEC presented lower FEV1 at early adolescence compared to high-SEC counterparts, but differences seem to diminish with height growth. The effect of paternal occupational position in lung function growth trajectories was moderated by height, thus individuals from fathers with less advantaged occupational position had lower FEV1 at early adolescence, but they had a faster FEV1 growth over time. Individuals from most disadvantaged SEC presented lower lung function at early adolescence compared to high-SEC counterparts; nevertheless, a catch-up growth was observed. Lower socioeconomic circumstances were previously associated with reduced lung function and a higher risk of respiratory diseases in adults. Fewer studies analysed the effects of early-life socioeconomic circumstances in lung function growth during adolescence. Disadvantaged socioeconomic circumstances were associated with lower lung function in early adolescence. However, social differences diminished over adolescence, suggesting a catch-up growth of lung function among those from lower socioeconomic circumstances. An improved understanding of the mechanism underlying lung function catch-up (or the absence of catch-up) might support interventions to narrow social inequalities in respiratory health and should be further investigated.

Life course partnership and employment trajectories and parental caregiving at age 55: prospective findings from a British Birth Cohort Study

We investigate whether work and partnership life courses between ages 16 and 54 predict the likelihood of providing care to a parent or parent-in-law at age 55, and whether these associations differ by gender or early life socio-economic circumstances. In the National Child Development Study (NCDS), fully adjusted models showed that strong life course ties to marriage were linked with a greater likelihood to provide parental care for both men and women. The longer women spent in part-time employment the more likely they were to provide care to a parent, while stronger life course ties to full-time employment were linked with a greater likelihood of providing care to a parent for men. The importance of part-time employment among women and long-term marriage for both men and women for uptake of parental care may imply a reduced pool of potential informal caregivers among subsequent generations for whom women have much stronger life course labour-market ties and life course partnerships have become more diverse.

Early life socioeconomic circumstances and cardiometabolic health in childhood: Evidence from the Generation XXI cohort

Social adversity is thought to become biologically embedded during sensitive periods of development which could set children on a trajectory of increased risk for later diseases. This study estimated the association between early socioeconomic circumstances and cardiometabolic biomarkers during childhood.We analyzed data from 2962 participants in the birth cohort Generation XXI. Early socioeconomic circumstances included parental education and occupation and household income measured at the child's birth; cardiometabolic biomarkers included a set of parameters that were determined at seven and 10years old. The association between early socioeconomic circumstances and cardiometabolic biomarkers in children aged seven and 10years old was estimated using generalized estimating equations.We observed, after adjustment for birth weight, sex, five-a-day fruit and vegetable intake and sedentary activity, that children with low educated mothers presented higher body mass index z-score (β=0.22; 95%CI: 0.12, 0.33), higher waist circumference (β=1.14; 95%CI: 0.55, 1.73) and increased systolic blood pressure z-score (β=0.15; 95%CI: 0.08, 0.22) at the age of seven. At 10years, children with mothers with low education, presented higher body mass index z-score (β =0.32; 95%CI: 0.21, 0.43), higher waist circumference (β=2.79; 95%CI: 1.94, 3.64), increased diastolic blood pressure z-score (β=0.11; 95%CI: 0.06, 0.17) and increased systolic blood pressure s-score (β=0.20; 95%CI: 0.12, 0.28). When repeated measures of cardiometabolic biomarkers were taken into account, the association between socioeconomic circumstances and cardiometabolic biomarkers remained significant.Low socioeconomic circumstances have a possible detrimental effect on children's cardiometabolic health. Thus, socioeconomic adversity might impact health outcomes already in the first decade of life, emphasizing the early social patterning of cardiometabolic health and the need of social policies targeting children and families to modify or reverse its negative impact on health.

Early-life socioeconomic circumstances explain health differences in old age, but not their evolution over time

BackgroundEarly-life socioeconomic circumstances (SEC) are associated with health in old age. However, epidemiological evidences on the influence of these early-life risk factors on trajectories of healthy ageing are inconsistent, preventing...

Welfare regimes modify the association of disadvantaged adult-life socioeconomic circumstances with self-rated health in old age.

Welfare regimes in Europe modify individuals' socioeconomic trajectories over their life-course, and, ultimately, the link between socioeconomic circumstances (SECs) and health. This paper aimed to assess whether the associations between life-course SECs (early-life, young adult-life, middle-age and old-age) and risk of poor self-rated health (SRH) trajectories in old age are modified by welfare regimes (Scandinavian [SC], Bismarckian [BM], Southern European [SE], Eastern European [EE]). We used data from the longitudinal SHARE survey. Early-life SECs consisted of four indicators of living conditions at age 10. Young adult-life, middle-age, and old-age SECs indicators were education, main occupation and satisfaction with household income, respectively. The association of life-course SECs with poor SRH trajectories was analysed by confounder-adjusted multilevel logistic regression models stratified by welfare regime. We included 24 011 participants (3626 in SC, 10 256 in BM, 6891 in SE, 3238 in EE) aged 50 to 96 years from 13 European countries. The risk of poor SRH increased gradually with early-life SECs from most advantaged to most disadvantaged. The addition of adult-life SECs differentially attenuated the association of early-life SECs and SRH at older age across regimes: education attenuated the association only in SC and SE regimes and occupation only in SC and BM regimes; satisfaction with household income attenuated the association across regimes. Early-life SECs have a long-lasting effect on SRH in all welfare regimes. Adult-life SECs attenuated this influence differently across welfare regimes.

Disadvantaged Early-Life Socioeconomic Circumstances Are Associated With Low Respiratory Function in Older Age.

Poor lung function in late life may stem from early-life risk factors, but the epidemiological evidence is inconsistent. We investigated whether individuals who experienced disadvantageous socioeconomic circumstances (SEC) in early life showed lower levels of respiratory function in older age, a steeper decline over time, and whether these relationships were explained by adult-life SEC, body mass index, and physical inactivity in older age. We used data from the Survey of Health Ageing and Retirement in Europe (2004-2015). Participants' peak expiratory flow (PEF) was assessed with a mini-Wright peak flow meter at second, fourth, and sixth waves. Confounder-adjusted linear mixed-effect models were used to examine the associations between early-life SEC and PEF in older age. A total of 21,734 adults aged 50-96 years (46,264 observations) were included in the analyses. Older adults with disadvantaged early-life SEC showed lower levels of PEF compared with those with advantaged early-life SEC. The association between early-life SEC and late-life PEF persisted after adjusting for adult-life SEC, smoking, physical inactivity, and body mass index. PEF declined with age, but the effect of early-life SEC on this decline was not consistent across robustness and sensitivity analyses. Early life is a sensitive period for respiratory health. Further considering the effect of SEC arising during this period may improve the prevention of chronic respiratory diseases.

Effect of Early- and Adult-Life Socioeconomic Circumstances on Physical Inactivity.

This study aimed to investigate the associations between early- and adult-life socioeconomic circumstances and physical inactivity (level and evolution) in aging using large-scale longitudinal data. This study used the Survey of Health Ageing and Retirement in Europe, a 10-yr population-based cohort study with repeated measurements in five waves, every 2 yr between 2004 and 2013. Self-reported physical inactivity (waves 1, 2, 4, and 5), household income (waves 1, 2, 4, and 5), educational attainment (wave of the first measurement occasion), and early-life socioeconomic circumstance (wave 3) were collected in 22,846 individuals 50 to 95 yr of age. Risk of physical inactivity was increased for women with the most disadvantaged early-life socioeconomic circumstances (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.20-1.86). With aging, the risk of physical inactivity increased for both sexes and was strongest for those with the most disadvantaged early-life socioeconomic circumstances (OR, 1.04 (95% CI, 1.02-1.06) for women; OR, 1.02 (95% CI, 1.00-1.05) for men), with the former effect being more robust than the latter one. The association between early-life socioeconomic circumstances and physical inactivity was mediated by adult-life socioeconomic circumstances, with education being the strongest mediator. Early-life socioeconomic circumstances predicted high levels of physical inactivity at older ages, but this effect was mediated by socioeconomic indicators in adult life. This finding has implications for public health policies, which should continue to promote education to reduce physical inactivity in people at older ages and to ensure optimal healthy aging trajectories, especially among women with disadvantaged early-life socioeconomic circumstances.

Association of parental education with tooth loss among Korean Elders

There are few reports showing an association between childhood socioeconomic circumstances and tooth loss among the elderly. The purpose of this study was (i) to examine the association between early childhood socioeconomic position (parental education level) and tooth loss and (ii) to determine the relative effects of the subjects' education level, occupation, and income on tooth loss in Korean elders. Data from the fourth and fifth Korea National Health and Nutritional Examination Survey on 8814 Korean elders (age ≥65years) were analyzed. Demographic factors (age, survey year, marital status, and residence area), health behaviors (dental check-up during the past year and cigarette smoking), and the presence of a somatic health problem (diabetes) were included in our gender-specific analyses. Tooth loss was defined as edentulism or severe tooth loss (<20 teeth). For our analyses, chi-square test and Student's t-tests and multiple logistic regressions were performed. A low parental education level was associated with elevated odds of edentulism (OR=1.87 for father's education and 1.52 for mother's education among male elders and OR=1.73 for father's education and 1.55 for mother's education among female elders) and with severe tooth loss (OR=1.58 for father's education and 1.53 for mother's education among male elders and OR=1.25 for father's education and 1.48 for mother's education among female elders). The association between parental education level and tooth loss was attenuated after adjusting for the subject's education level, occupation, and income. Relative magnitude of attenuation varied with personal factors (education>income>occupation). In a fully adjusted model, father's education level was significantly associated with edentate status (OR=1.96 for male elders and 1.46 for female elders), but not with severe tooth loss. Our results indicate that early life socioeconomic circumstances measured by the father's education level were independently associated with the edentate status of Korean elders.

Socioeconomic Position Early in Adolescence and Mode of Delivery Later in Life: Findings from a Portuguese Birth Cohort

ObjectiveThis study assessed the influence of socioeconomic position at 12 years of age (SEP-12) on the variability in cesarean rates later in life.MethodsAs part of the Portuguese Generation XXI birth cohort we evaluated 7358 women with a singleton pregnancy who delivered at five Portuguese public hospitals serving the region of Porto (April/2005–September/2006). Based on the twelve items that described socioeconomic circumstances at age 12, a latent class analysis was used to classify women’s SEP-12 as high, intermediate and low. Multiple Poisson regression was used to estimate adjusted risk ratio (RR) and respective 95% confidence interval (95% CI).ResultsThe cesarean rates in high, intermediate and low SEP-12 were, respectively, 40.9%, 37.5% and 40.5% (p = 0.100) among primiparous women; 14.2%, 11.6% and 15.5% (p = 0.04) among multiparous women with no previous cesarean and 78.6%, 72.2% and 70.0% (p = 0.08) among women with a previous cesarean. A low to moderate association between SEP-12 and cesarean rates was observed among multiparous women with a previous cesarean, illustrating that women from higher SEP-12 were more likely to have a surgical delivery (RR = 1.12;95%CI:1.01–1.24 comparing high with low SEP-12 and RR = 1.03:95%CI:0.94–1.14 comparing intermediate with low SEP-12) not explained by potential mediating factors. No such association was found either in primiparous or in multiparous women without a previous cesarean.ConclusionsThe association between SEP-12 and cesarean rates suggests the effect of past socioeconomic context on the decision concerning the mode of delivery, but only among women who experienced a previous cesarean. Accordingly, it appears that early-life socioeconomic circumstances drive cesarean rates but the effect can be modified by lived experiences concerning childbirth.

Biological embedding of early-life exposures and disease risk in humans: a role for DNA methylation.

Following wider acceptance of 'the thrifty phenotype' hypothesis and the convincing evidence that early-life exposures can influence adult health even decades after the exposure, much interest has been placed on the mechanisms through which early-life exposures become biologically embedded. In this review, we summarize the current literature regarding biological embedding of early-life experiences. To this end, we conducted a literature search to identify studies investigating early-life exposures in relation to DNA methylation changes. In addition, we summarize the challenges faced in investigations of epigenetic effects, stemming from the peculiarities of this emergent and complex field. A proper systematic review and meta-analyses were not feasible given the nature of the evidence. We identified seven studies on early-life socio-economic circumstances, 10 studies on childhood obesity and six studies on early-life nutrition all relating to DNA methylation changes that met the stipulated inclusion criteria. The pool of evidence gathered, albeit small, favours a role of epigenetics and DNA methylation in biological embedding, but replication of findings, multiple comparison corrections, publication bias and causality are concerns remaining to be addressed in future investigations. Based on these results, we hypothesize that epigenetics, in particular DNA methylation, is a plausible mechanism through which early-life exposures are biologically embedded. This review describes the current status of the field and acts as a stepping stone for future, better designed investigations on how early-life exposures might become biologically embedded through epigenetic effects.

Birth weight and maternal socioeconomic circumstances were inversely related to systolic blood pressure among Afro-Caribbean young adults

ObjectivesIn this study, we examined the effects of birth weight (BWT) and early life socioeconomic circumstances (SEC) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) among Jamaican young adults. Study Design and SettingLongitudinal study of 364 men and 430 women from the Jamaica 1986 Birth Cohort Study. Information on BWT and maternal SEC at child's birth was linked to information collected at 18–20 years old. Sex-specific multilevel linear regression models were used to examine whether adult SBP/DBP was associated with BWT and maternal SEC. ResultsIn unadjusted models, SBP was inversely related to BWT z-score in both men (β, −0.82 mm Hg) and women (β, −1.18 mm Hg) but achieved statistical significance for women only. In the fully adjusted model, one standard deviation increase in BWT was associated with 1.16 mm Hg reduction in SBP among men [95% confidence interval (CI): 2.15, 0.17; P = 0.021] and 1.34 mm Hg reduction in SBP among women (95% CI: 2.21, 0.47; P = 0.003). Participants whose mothers had lower SEC had higher SBP compared with those with mothers of high SEC (β, 3.4–4.8 mm Hg for men, P < 0.05 for all SEC categories and 1.8–2.1 for women, P > 0.05). ConclusionSBP was inversely related to maternal SEC and BWT among Jamaican young adults.

Early life predictors of blood pressure in Afro-Caribbean young adults: The Jamaica 1986 birth cohort study

Objective: In this study we examined the effects of birth weight (BWT) and early life socioeconomic circumstances (SEC) on systolic and diastolic blood pressure (SBP, DBP) among Jamaican young adults. Study Design and Setting: Longitudinal study of 364 men and 430 women from the Jamaica 1986 Birth Cohort Study. Information on maternal SEC at birth and BWT were linked to information collected at 18-20 years old. Sex-specific multilevel linear regression models were used to examine whether adult SBP and DBP were associated with BWT and maternal SEC. Results: In unadjusted models, SBP was inversely related to BWT z-score in both men and women (beta = -0.82 and -1.18, respectively) but achieved statistical significance for women only. After adjustments for current age, current BMI, current height, maternal age and mother's occupation at child's birth, a one standard deviation (SD) unit increase in BWT was associated with 1.16 mmHg reduction in SBP among men (95%CI -2.15, -0.17; p=0.021) and a 1.34 mmHg reduction in SBP among women (95%CI -2.21, -0.47; p=0.003). High maternal occupational SEC at birth was consistently associated with lowest SBP across the standardized BWT distribution. SBP was 2-4 mmHg lower among those with high SEC mothers at birth than among those whose mothers were unemployed at birth. Conclusion: SBP at 18-20 years-old was lowest among those whose mothers had high SEC at birth and was inversely related to BWT.

The socioeconomic origins of physical functioning among older U.S. adults.

Mounting evidence finds that adult health reflects socioeconomic circumstances (SES) in early life and adulthood. However, it is unclear how the health consequences of SES in early life and adulthood accumulate-for example, additively, synergistically. This study tests four hypotheses about how the health effects of early-life SES (measured by parental education) and adult SES (measured by own education) accumulate to shape functional limitations, whether the accumulation differs between men and women, and the extent to which key mechanisms explain the accumulation. It uses data from the 1994-2010 Health and Retirement Study on U.S. adults 50-100 years of age (N=24,026). The physical functioning benefits of parental and own education accumulated additively among men. While the physical functioning benefits generally accumulated among women, the functioning benefits from one's own education were dampened among women with low-educated mothers. The dampening partly reflected a strong tie between mothers' education level and women's obesity risk. Taken together, the findings reveal subtle differences between men and women in the life course origins of physical functioning. They also shed light on a key mechanism-obesity-that may help explain why a growing number of studies find that early-life SES is especially important for women's health.

Do different measures of early life socioeconomic circumstances predict adult mortality? Evidence from the British Whitehall II and French GAZEL studies

BackgroundFather's occupational position, education and height have all been used to examine the effects of adverse early life socioeconomic circumstances on health, but it remains unknown whether they predict mortality...

Socioeconomic Characteristics of the Community in Childhood and Cognition in Old Age

ABSTRACT We examined the relation of early life socioeconomic circumstances to cognition in older residents of a biracial urban community. Participants had brief cognitive testing three times at approximately 3-year intervals. At baseline, information about early life household and county socioeconomic level was collected. In mixed-effects models adjusted for age, sex, race, and education, both early life household and county socioeconomic levels were positively associated with baseline level of cognition but unrelated to cognitive decline. The results suggest that socioeconomic conditions in early life are associated with level of cognitive function in old age but not with rate of cognitive decline.