Early Life Socioeconomic Disadvantage Research Articles

Early life social conditions and adverse experiences are associated with childhood BMI and perceived overeating.

Early life socioeconomic disadvantage and adverse experiences may lead to overeating, which is in turn associated with increased body mass index (BMI). However, recent evidence indicated that the association between childhood BMI and overeating might be bidirectional. This bidirectionality prompts the need for further investigation of early life predictors of BMI in childhood. To longitudinally assess the directionality of the association between childhood BMI and perceived overeating and to investigate their antecedent early life predictors. The sample included data from 5151 children from the ELSPAC study, collected between 18 months and 11 years of child age. The outcomes were child BMI and mother-reported overeating, assessed at the age of 3, 5, 7 and 11 years. Predictors included maternal BMI, maternal education, single parenthood, financial difficulties and adverse childhood experiences (ACEs) reported by parents and paediatricians. The random intercept cross-lagged panel model was applied. The mean child's BMI at age 3 was 15.59 kg/m2 and increased to 17.86 kg/m2 at age 11. The percentage of parent-reported overeating increased in the following period, from about 12% at age 3 to 17% at age 11. The results showed temporal stability in perceived overeating and BMI, with a bidirectional relationship strengthening over time. The child's BMI was associated with maternal BMI. Maternal BMI was positively associated with child-perceived overeating, but a stronger effect was found for ACEs. ACEs mediated the impact of maternal education, financial difficulties and single parenthood on overeating. We observed stable bidirectional associations between BMI and perceived overeating. The results indicated two main pathways: one linked to maternal BMI and early childhood BMI increase followed by perceived overeating and the second associated with ACEs mediating the effect of early childhood social factors on perceived overeating, leading to gradual BMI gain.

Early Life Disadvantage and the Risk of Depressive Symptoms among Young Black Women.

We examined the association between early-life socioeconomic disadvantage and depressive symptoms in adulthood and assessed whether social factors in adulthood modify the association. The11-item Center for Epidemiologic Studies-Depression Scale (CES-D) assessed adult depressive symptoms among 1612 Black women and other participants with a uterus (hereafter participants) in the Study of Environment, Lifestyle and Fibroids. Baseline self-reported childhood factors (i.e., parents in the household, mother's educational attainment, food insecurity, neighborhood safety, childhood income, and quiet bedroom for sleep) were included in a latent class analysis to derive an early life disadvantage construct. Multivariable log-binomial models estimated the association between early life disadvantage and adult depressive symptoms. Potential effect modifiers included adult educational attainment, social support, and financial difficulty. Participants classified as having high early life disadvantage had 1.34 times (95% CI: 1.20, 1.49) the risk of high depressive symptoms than those in the low early life disadvantage class after adjusting for age, first born status, and childhood health. Adult educational attainment and social support modified the association. Early life disadvantage increased the risk of depressive symptoms in adulthood. Participants with at least some college education and with high social support had greater risk than those with less than college education and low social support, respectively. Thus, the mental health ofBlack women and other participants with a uterusexposed to early life disadvantage do not necessarily benefit from higher education or from social support.

The Role of Place of Birth and Residence in Puerto Rican Health Disparities: Evidence From Disability Prevalence Among Archipelago- Vs. Mainland-Born Puerto Ricans.

Objectives: This paper provides new estimates of disability prevalence for the archipelago and mainland-residing Puerto Rican populations ages 40 and above and compares disability by place of birth and place of residence to investigate drivers of middle and older age health. Methods: Large nationally representative samples from 2013 to 2017 American Community Survey and Puerto Rico Community Survey data are used to estimate age-specific disability prevalence for archipelago-born/archipelago-residing, archipelago-born/mainland-residing, mainland-born/mainland-residing Puerto Ricans. Results: Mainland-born/mainland-residing Puerto Ricans have the lowest age-adjusted disability rates and archipelago-born/archipelago-residing Puerto Ricans have the highest rates. Differences in education explain part of this disparity. Discussion: Similarities in disability prevalence are strongest based on where one was born as opposed to current residence, pointing to early life as a critical period in the disablement process for later-life health. Early life socio-economic disadvantage on the archipelago may have an enduring impact on later-life disability prevalence for archipelago-born Puerto Ricans.

Early-Life Socioeconomic Disadvantage and Health in Late Middle-Age: Importance of Heterogeneous Income Trajectories.

This paper aims to investigate heterogeneous income changes and whether the income trajectories moderate effects of early socioeconomic disadvantage on health in late middle age. The sample was restricted to 9,056 middle-aged adults from the Health and Retirement Study (1998-2010). Through a latent class growth analysis, six patterns of income changes were identified: constantly low, constantly moderate, constantly high & increasing, high to low, moderate to high, and high to moderate. The Constantly low group more frequently displayed depressive symptoms if exposed to early socioeconomic disadvantage and Constantly low income mobility. Individuals who experienced early socioeconomic disadvantage and a downward income mobility in middle age tended to have multiple chronic conditions while there was no moderating effect of income changes for mobility functional limitations. These findings suggest that not all health outcomes are programmed in early life: Disadvantage can be somewhat alleviated through stable and better later-life economic status.

844Considering child maltreatment in social inequalities of educational achievement: a whole-of-population data linkage study

Abstract Background Strategies aimed at reducing health inequalities include a focus on improving education, a key determinant of health and labour market outcomes. Studies have demonstrated that both early life socioeconomic disadvantage and child maltreatment result in poorer educational outcomes, but have not examined the effect of the combination of these adversities. Methods This study used de-identified, linked government administrative data from the South Australian Early Childhood Data Project on children born in South Australia who completed Year 5 National Assessment Program—Literacy and Numeracy (NAPLAN) during 2008-2015 (n = 61,445), and their corresponding birth, perinatal, school enrolment and child protection system data. Results Overall, 23.7% (95% CI 23.4-24.1) had a poor NAPLAN outcome (at or below national minimum standard on three or more of the five domains - reading, writing, spelling, grammar and punctuation, numeracy). This proportion was approximately double for children who experienced substantiated maltreatment compared to children who did not experience contact with the child protection system, irrespective of the social circumstances (parental education, employment, housing and area-level disadvantage) in which the child lived. Conclusions Social advantage is not sufficient to protect children from poor educational outcomes if they experience substantiated maltreatment. Interventions and services will need to focus on child maltreatment, in addition to socioeconomic factors, to improve educational outcomes in the population. Key messages Within each social group, from advantaged to disadvantaged children, the risk of poor NAPLAN outcomes was greater for children who had contact with the child protection system.

Child maltreatment, early life socioeconomic disadvantage and all-cause mortality in mid-adulthood: findings from a prospective British birth cohort

ObjectivesEarly-life adversities (ELAs) such as child maltreatment (neglect and abuse) and socioeconomic disadvantage have been associated with adult mortality. However, evidence is sparse for specific types of ELA. We aimed...

Adopting a "Compound" Exposome Approach in Environmental Aging Biomarker Research: A Call to Action for Advancing Racial Health Equity.

Background:In June 2020, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop focused on integrating the science of aging and environmental health research. The concurrent COVID-19 pandemic and national attention on racism exposed shortcomings in the environmental research field’s conceptualization and methodological use of race, which have subsequently hindered the ability of research to address racial health disparities. By the workshop’s conclusion, the authors deduced that the utility of environmental aging biomarkers—aging biomarkers shown to be specifically influenced by environmental exposures—would be greatly diminished if these biomarkers are developed absent of considerations of broader societal factors—like structural racism—that impinge on racial health equity.Objectives:The authors reached a post-workshop consensus recommendation: To advance racial health equity, a “compound” exposome approach should be widely adopted in environmental aging biomarker research. We present this recommendation here.Discussion:The authors believe that without explicit considerations of racial health equity, people in most need of the benefits afforded by a better understanding of the relationships between exposures and aging will be the least likely to receive them because biomarkers may not encompass cumulative impacts from their unique social and environmental stressors. Employing an exposome approach that allows for more comprehensive exposure–disease pathway characterization across broad domains, including the social exposome and neighborhood factors, is the first step. Exposome-centered study designs must then be supported with efforts aimed at increasing the recruitment and retention of racially diverse study populations and researchers and further “compounded” with strategies directed at improving the use and interpretation of race throughout the publication and dissemination process. This compound exposome approach maximizes the ability of our science to identify environmental aging biomarkers that explicate racial disparities in health and best positions the environmental research community to contribute to the elimination of racial health disparities. https://doi.org/10.1289/EHP8392

Gene regulation contributes to explain the impact of early life socioeconomic disadvantage on adult inflammatory levels in two cohort studies

Individuals experiencing socioeconomic disadvantage in childhood have a higher rate of inflammation-related diseases decades later. Little is known about the mechanisms linking early life experiences to the functioning of the immune system in adulthood. To address this, we explore the relationship across social-to-biological layers of early life social exposures on levels of adulthood inflammation and the mediating role of gene regulatory mechanisms, epigenetic and transcriptomic profiling from blood, in 2,329 individuals from two European cohort studies. Consistently across both studies, we find transcriptional activity explains a substantive proportion (78% and 26%) of the estimated effect of early life disadvantaged social exposures on levels of adulthood inflammation. Furthermore, we show that mechanisms other than cis DNA methylation may regulate those transcriptional fingerprints. These results further our understanding of social-to-biological transitions by pinpointing the role of gene regulation that cannot fully be explained by differential cis DNA methylation.

Duration of Breastfeeding Mediates the Association Between Early Socioeconomic Risk and Child Vocabulary at Age 4.

Early-life socioeconomic disadvantage is associated with both obesity and lower cognitive abilities in childhood. One theorized underlying mechanism is breastfeeding duration because breast milk contains nutrients that can promote healthy adiposity profiles and stimulate brain development. However, studies have rarely examined these potential associations with child body mass index (BMI) in high-income Western countries, much less investigated breastfeeding duration as a mediator of the relationship between childhood socioeconomic status (SES) and later child vocabulary. The current study aimed to prospectively examine associations between early-life family socioeconomic risk and both child BMI and vocabulary at age 4 in a Norwegian cohort and the potential mediating contribution of breastfeeding duration. The Behavior Outlook Norwegian Developmental Study (BONDS) followed 1159 families and their children from 6 months of age onward. Parents reported on SES and breastfeeding duration in infancy, and child BMI and vocabulary ability were assessed at age 4. Direct and indirect effects were estimated using a path model that adjusted for several demographic and perinatal covariates (e.g., parental nativity and birthweight). Family socioeconomic risk was significantly and negatively related to child vocabulary but was unrelated to child BMI. In addition, breastfeeding duration mediated the association between family socioeconomic risk and child vocabulary, with greater family socioeconomic risk associated with a shorter breastfeeding duration, which, in turn, predicted poorer child vocabulary. The current findings suggest that longer breastfeeding duration is a viable target for preventatively promoting child vocabulary, especially among families at socioeconomic risk.

Multiple risk behaviour and socioeconomic status during the transition from adolescence to adulthood

Abstract Background Multiple risk behaviour (MRB) means the occurrence of two or more risk behaviours and is associated with a range of negative outcomes. What is unknown is whether MRB is associated with socioeconomic status (SES) in adulthood. This study aimed to examine the association between adolescent MRB and young adult SES and whether those who experienced early life socioeconomic disadvantage also faced greater negative impact of adolescent MRB. Methods Two prospective birth cohort studies; British Cohort Study 1970 (BCS70) and Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991-1992, were used. Logistic regression assessed the association between MRB and young adult SES. Three early life SES variables were examined for their moderating effect on the association using models with and without interaction parameters. Likelihood ratio tests ≤p=0.05 indicated evidence to support moderation. Multiple imputation was used to account for missing data. Results Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response, with each additional risk behaviour resulting in reduced odds of university degree attainment. In BCS70, maternal education (p = 0.03), parental occupation (p = 0.009) and household income (p = 0.03) moderated the effect of adolescent MRB on young adult SES. The effect of MRB on university degree attainment was stronger for those from poorer socioeconomic backgrounds. No evidence of moderation was found in ALSPAC. Conclusions Adolescence is a critical time to address MRB as behaviours established here may have effects in adulthood. Intervening on adolescent MRB may improve later SES and thus health outcomes later in life. Evidence for a moderation effect in the BCS70 but not ALSPAC suggests that measures should be investigated for their ability to capture the nuance of contemporary young adult SES. Key messages Intervening on adolescent multiple risk behaviour could improve socioeconomic life chances in young adulthood. Variables that capture the nuance of contemporary young adult socioeconomic status should be explored.

Early Life Socioeconomic Disadvantage and Epigenetic Programming of a Pro-inflammatory Phenotype: a Review of Recent Evidence

A growing body of literature suggests that early life socioeconomic disadvantage (SD) may play a key role in shaping a pro-inflammatory phenotype hypothesized to result from programming of cells of the innate immune system (i.e., monocytes and macrophages) for desensitization to glucocorticoid signaling and exacerbated inflammatory response to immune stimuli, yet understanding of the biologic pathways by which such programming may occur remains limited. The purpose of this review is to discuss the current research supporting the hypothesis that early life SD is associated with a pro-inflammatory phenotype beginning in childhood and highlight recent findings regarding the role that epigenetic programming via DNA methylation (DNAm) specifically, may serve as a biologic mediator of these associations. Gaps in knowledge and recommendations for future research are also discussed. Findings regarding the association between early life SD and DNAm of genes that may be involved in shaping a pro-inflammatory phenotype are mixed, but lend some support for epigenetic alterations to genes regulating inflammatory processes as a mediator of this association. Studies which integrate data on DNAm, gene expression, and markers of a pro-inflammatory phenotype beginning early in life and over time are ultimately needed to fully understand the role of epigenetic programming in shaping this adverse immune phenotype in those born into socioeconomically disadvantaged environments. Epigenetic programming of a pro-inflammatory phenotype represents a plausible and understudied pathway by which socioeconomic disparities in chronic disease develop across the lifecourse and are perpetuated across generations.

Early-life socioeconomic disadvantage, not current, predicts accelerated epigenetic aging of monocytes

Low socioeconomic status (SES) in early-life and adulthood independently contribute to increased risk for aging-related chronic diseases. One mechanistic hypothesis for these associations involves faster cellular aging of immune cells, which could plausibly contribute to chronic disease pathogenesis by compromising host resistance and/or up-regulating inflammation. However, little is known about the association between life-course SES and cellular aging. The present study examines the association of early-life and current SES with a novel biomarker of cellular aging termed the “epigenetic clock,” in monocytes. Additionally, we examine health behaviors and depressive symptoms as potential explanatory pathways. The study involved 335 participants between the ages of 15 and 55 from Vancouver, Canada and surrounding areas. Enrolled participants had to fit into four life-course SES trajectories, corresponding to low-low, low-high, high-low and high-high combinations of early-life (ages 0 to 5) and current SES respectively. Cellular aging of monocytes was measured using Horvath's DNA methylation derived measure of epigenetic age acceleration. Results indicated that socioeconomic disadvantage during early-life, but not later in life, was associated with accelerated epigenetic aging of monocytes. No early-life SES by current SES interaction was detected, suggesting that socioeconomic mobility is unrelated to epigenetic age acceleration. In path analyses, neither current health behaviors nor current depressive symptoms emerged as mediators of the early-life SES effect. These findings suggest socioeconomic disadvantage in early-life is independently predictive of cellular aging of immune cells, with potential implications for aging-related diseases later in life.

Early-Life Socioeconomic Disadvantage and Metabolic Health Disparities

A quarter of the world's population have metabolic syndrome (MetS). MetS prevalence is stratified by socioeconomic status (SES), such that low SES is associated with higher MetS risk. The present study examined the relative roles of early-life SES and current SES in explaining MetS risk. Participants (N = 354; ages = 15-55 years, M [SD] = 36.5 [10.7] years; 55% female; 72.9% white, 16.9% Asian, 10.2% others) were evaluated for SES and MetS. All were in good health, defined as free of chronic medical illness and acute infectious disease. Using occupational status as a proxy for SES, we recruited roughly equal numbers of participants with low-low, low-high, high-low, and high-high combinations of early-life and current SES. We used the International Diabetes Federation definition for MetS using race- and sex-specific cutoffs for waist circumference, triglyceride levels, high-density lipoprotein cholesterol, blood pressure, and glycosylated hemoglobin levels. Analyses revealed a main effect of low early-life SES on increased MetS risk according to the three separate definitions. They included the traditional MetS diagnosis (odds ratio [OR] = 1.53, confidence interval [CI] = 1.01-2.33, p = .044), the number of MetS components for which diagnostic thresholds were met (OR = 1.61, CI = 1.10-2.38, p = .015), and a continuous indicator of metabolic risk based on factor analysis (F(1,350) = 6.71, p = .010, partial η = .019). There was also a significant interaction of early-life SES and current SES in predicting MetS diagnosis (OR = 1.54, CI = 1.02-2.34). The main effects of current SES were nonsignificant in all analyses. These findings suggest that MetS health disparities originate in childhood, which may be an opportune period for interventions.

Estimating the effect of childhood socioeconomic disadvantage on oral cancer in India using marginal structural models.

Early life socioeconomic disadvantage could affect adult health directly or indirectly. To the best of our knowledge, there are no studies of the direct effect of early life socioeconomic conditions on oral cancer occurrence in adult life. We conducted a multicenter, hospital-based, case-control study in India between 2011 and 2012 on 180 histopathologically confirmed incident oral and/or oropharyngeal cancer cases, aged 18 years or more, and 272 controls that included hospital visitors, who were not diagnosed with any cancer in the same hospitals. Life-course data were collected on socioeconomic conditions, risk factors, and parental behavior through interview employing a life grid. The early life socioeconomic conditions measure was determined by occupation of the head of household in childhood. Adult socioeconomic measures included participant's education and current occupation of the head of household. Marginal structural models with stabilized inverse probability weights were used to estimate the controlled direct effects of early life socioeconomic conditions on oral cancer. The total effect model showed that those in the low socioeconomic conditions in the early years of childhood had 60% (risk ratio [RR] = 1.6 [95% confidence interval {CI} = 1.4, 1.9]) increased risk of oral cancer. From the marginal structural models, the estimated risk for developing oral cancer among those in low early life socioeconomic conditions was 50% (RR = 1.5 [95% CI = 1.4, 1.5]), 20% (RR = 1.2 [95% CI = 0.9, 1.7]), and 90% (RR = 1.9 [95% CI = 1.7, 2.2]) greater than those in the high socioeconomic conditions when controlled for smoking, chewing, and alcohol, respectively. When all the three mediators were controlled in a marginal structural model, the RR was 1.3 (95% CI = 1.0, 1.6). Early life low socioeconomic condition had a controlled direct effect on oral cancer when smoking, chewing tobacco, and alcohol were separately adjusted in marginal structural models.

Early-life social origins of later-life body weight: The role of socioeconomic status and health behaviors over the life course

Using the 1957–2004 data from the Wisconsin Longitudinal Study, we apply structural equation modeling to examine gender-specific effects of family socioeconomic status (SES) at age 18 on body weight at age 65. We further explore SES and health behaviors over the life course as mechanisms linking family background and later-life body weight. We find that early-life socioeconomic disadvantage is related to higher body weight at age 65 and a steeper weight increase between midlife and late life. These adverse effects are stronger among women than men. Significant mediators of the effect of parents’ SES include adolescent body mass (especially among women) as well as exercise and SES in midlife. Yet, consistent with the critical period mechanism, the effect of early-life SES on late-life body weight persists net of all mediating variables. This study expands current understanding of life-course mechanisms that contribute to obesity and increase biological vulnerability to social disadvantage.

Risk factors across the life course and dementia in a Brazilian population: results from the Sao Paulo Ageing & Health Study (SPAH)

Several mechanisms have been suggested to explain the association between adversities across life and dementia. This study aimed to investigate the association between indicators of socioeconomic disadvantages throughout the life-course and dementia among older adults in Sao Paulo, Brazil and to explore possible causal pathways. We used baseline data from the SPAH study which involved participants aged 65 years and older (n = 2005). The outcome of interest was prevalent dementia. Exposures included in the analyses were socioeconomic position (SEP) indicators in childhood (place of birth and literacy) and adulthood (occupation and income), anthropometric measurements as markers of intrauterine and childhood environment (head circumference and leg length), smoking, diabetes and hypertension. Logistic regression models were used to test the hypothesized pathways and to assess whether there was an association between cumulative adversities across the life course and prevalent dementia. Indicators of socioeconomic disadvantage in early life were associated with increased prevalence of dementia. This association was partially mediated through adulthood SEP. Head circumference and leg length were also clearly associated with dementia but there was no evidence that this association was mediated by early life socioeconomic disadvantage. There was an association between cumulative unfavourable conditions across the life course and dementia. Early life disadvantages seem to operate through biological mechanisms associated with passive brain reserve and opportunities in life representing active cognitive reserve. Prevention of dementia should start early in life and continue through life span as seen with many other chronic diseases.