Early Socioeconomic Adversity Research Articles

A longitudinal analysis of health inequalities from adolescence to young adulthood and their underlying causes

Research suggests that children of low-educated parents face greater health burdens during the passage from adolescence to young adulthood, as they are more likely to become low-educated themselves, establish behavioural and psychosocial disadvantages, or being exposed to unhealthy working conditions. However, studies examining the development and drivers of health inequalities during this particular life stage are limited in number and have produced varied results. This study investigates trajectories of self-rated health and overweight from 14 to 25 years of age, stratified by parental education, and explores the role of potential mediators (educational achievement, health behaviours, psychosocial factors, working conditions). We rely on prospective cohort data from the National Educational Panel Study (NEPS), a representative sample of 14,981 German ninth graders interviewed yearly from 2011 to 2021 (n = 90,096 person-years). First, we estimated random-effects growth curves for self-rated health and overweight over participants’ age and calculated the average marginal effect of high versus low parental education. Second, a series of simulation-based mediation analyses were performed to test how much of health inequalities were explained by children’s educational attainment (years of school education, years in university), health behaviours (smoking, alcohol, physical inactivity), psychosocial factors (number of grade repetitions, years in unemployment, chronic stress, self-esteem) and working conditions (physical and psychosocial job demands). We accounted for potential confounding by controlling for age, sex, migration background, residential area, household composition, and interview mode. Results show that higher parental education was related to higher self-rated health and lower probabilities of being overweight. Interaction between parental education and age indicated that, after some equalisation in late adolescence, health inequalities increased in young adulthood. Furthermore, educational attainment, health behaviours, psychosocial factors, and early-career working conditions played a significant role in mediating health inequalities. Of the variables examined, the level of school education and years spent in university were particular strong mediating factors. School education accounted for around one-third of the inequalities in self-rated health and one-fifth of the differences in overweight among individuals. Results support the idea that the transition to adulthood is a sensitive period in life and that early socio-economic adversity increases the likelihood to accumulate health disadvantages in multiple dimensions. In Germany, a country with comparatively low educational mobility, intergenerational continuities in class location seem to play a key role in the explanation of health inequalities in youth.

Concurrent and prospective associations between family socioeconomic status, social support and salivary diurnal and hair cortisol in adolescence.

Exposure to socioeconomic adversity is hypothesized to impact hypothalamic-pituitary-adrenal (HPA) axis activity and cortisol secretion, but existing evidence is inconsistent. Yet, few studies have investigated this association using a developmental approach that considers potential protective contextual factors. This study examined the role of stability and changes in family socioeconomic status (SES) in the prediction of multiple cortisol indicators and tested whether social support moderated these associations. Participants were part of a population-based sample of twin pairs recruited at birth. Family SES was assessed in early childhood (ages 0-5) and mid-adolescence (age 14). Social support was assessed at ages 14 and 19. Diurnal cortisol (n = 569) was measured at age 14 at awakening, 30 min later, in the afternoon and evening over four non-consecutive days. Hair cortisol concentration (HCC, n = 704) was measured at age 19. All data were collected before the pandemic and multilevel regression models were conducted to account for the nested data structure. Youth exposed to lower family SES levels in childhood and mid-adolescence had a flatter diurnal slope and higher HCC compared with those who experienced upward socioeconomic mobility in mid-adolescence. Contrastingly, mid-adolescence SES showed no association with the diurnal slope or HCC for youth from higher-SES households in early childhood. Moreover, youth raised in higher-SES families in early childhood had a higher CAR in mid-adolescence if they reported greater social support in mid-adolescence. Social support also moderated the SES-cortisol association in mid-adolescence, with higher-SES youth showing higher awakening cortisol secretion when reporting more social support. Our findings support the hypothesis that early socioeconomic adversity sensitizes HPA axis activity to later socioeconomic disadvantage, which may bear consequences for socioemotional and behavioral functioning.

Associations between family socioeconomic mobility during childhood and adolescence and diurnal and hair cortisol among adolescent twins

Although exposure to socioeconomic hardship is hypothesized to induce dysregulation in hypothalamic-pituitary-adrenal (HPA) axis activity and cortisol secretion, evidence remains inconsistent. Yet, few studies have investigated this association according to a developmental approach sensitive to the social context likely to exacerbate and mitigate this association. To examine whether childhood family socioeconomic status (SES) sensitizes the association between mid-adolescence SES and multiple indicators of cortisol secretion. Participants were twin pairs reared together with measures of SES collected in early childhood (ages 0–5) and mid-adolescence (age 14). Diurnal cortisol (n=592 twin pairs) was measured at age 14 at awakening, 30 min later, in the afternoon and evening over four non-consecutive days. Hair cortisol (n=422 twin pairs) was measured at age 19. Our findings revealed that youths experiencing lower SES levels throughout childhood and adolescence had a flatter diurnal slope and higher hair cortisol levels in comparison to those who experienced upward socioeconomic mobility from childhood to mid-adolescence. Moreover, youths who experienced downward socioeconomic mobility showed higher hair cortisol levels, except for those who were raised in higher-SES households during early childhood. Our study supports the hypothesis that early socioeconomic adversity may sensitize HPA axis activity to later socioeconomic disadvantage, which may bear consequences for socioemotional and behavioral functioning.

Early socioeconomic adversity and young adult diabetic risk: an investigation of genetically informed biopsychosocial processes over the life course

ABSTRACT The present study investigated a comprehensive model that integrates contributions of early socioeconomic adversity (ESA) and multiple polygenic scores (PGSs) through different mechanisms leading to diabetic risk in early adulthood. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. The results showed that both ESA and PGSs were involved in different mechanisms. ESA contributed additively to educational failures, BMI, depressive symptoms, and diabetes risk over the life course (an additive process). Also, ESA launched a cascading process that connected these outcomes in a successively contingent manner. In addition to ESA, youths’ multiple PGSs directly contributed to educational, psychological, and BMI outcomes. Multiple PGSs for education, BMI, and type 2 diabetes influenced not only youth outcomes that they were supposed to predict directly but also additional youth outcomes showing biological pleiotropy. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental and health outcomes.

Patterns of Co-occurring Developmental Failures in Adolescence: Socioeconomic andGenetic Antecedents and Health Outcomes in Adulthood

ABSTRACT This study investigates (1) conjoint latent classes of adolescent co-occurring developmental problems (obesity, depressive symptoms, and low educational attainment), (2) socioeconomic and genetic influences on these classes of adolescents’ problem trajectories, and (3) physical health consequences of those latent classes. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 9,107; mean age = 15.5 years; Female = 52.9 per cent) were used to identify classes of early socioeconomic adversity and conjoint trajectory groups of co-occurring developmental problems. Profiles of social antecedents, genetic endowments (polygenic scores), and physical health outcomes in young adulthood were compared across identified four conjoint trajectory risk groups (overall high-risk, overall low-risk, BMI-risk or obesity, low education-risk). The results showed that youth with overall high-risk and BMI/education-specific risk trajectory groups were more likely to be Black or Hispanic, reported more adverse socioeconomic characteristics and genetic endowment, and averaged significantly poorer physical health in young adulthood compared with youth in the overall low-risk problem trajectory group. Less pronounced differences emerged between the high-risk and problem-specific-risk groups. The findings highlight heterogeneity in adolescent co-occurring developmental problems. Adolescent heterogeneous problem co-development is associated with background socioeconomic and genetic characteristics and physical health in young adulthood.

Early life course processes leading to educational and economic attainment in young adulthood: Contributions of early socioeconomic adversity and education polygenic score.

The present study investigated an integrated life course model, drawn from the life course theoretical perspective, to elucidate youth’s additive, cascading, and cumulative life course processes stemming from early socioeconomic adversity and education polygenic score (education PGS) as well as potential interactions between them (GxE), which contribute to subsequent young adult socioeconomic outcomes. Additionally, the independent, varying associations among social and genetic predictors, life-stage specific educational outcomes (educational achievement in adolescence and educational attainment, in later stages), and young adult economic outcomes were examined. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. Early family socioeconomic adversity and individual education PGS were associated with life stage-specific educational outcomes through additive and cascading processes linked to young adults’ economic outcomes (personal earnings) through a cumulative process. A GxE moderation existed between individuals’ education PGS and early socioeconomic adversity at multiple life stages, explaining variation in adolescent educational outcomes. Both early socioeconomic adversity and education PGS were persistently associated with youth’s educational and economic outcomes throughout the early life course. In sum, the findings based on the integrated life course model showed how additive, cascading, and cumulative processes were related and conditioned one another, generating specific life course patterns and outcomes. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental characteristics.

How Early Socioeconomic Adversity Combines With BMI-Linked Genetics to Launch Adverse Developmental Processes Leading to Economic Hardship

The present study used a sample of 9,100 youth from The National Longitudinal Study of Adolescent to Adult Health to identify how early socioeconomic adversity and BMI-related genetics combine to influence youth BMI and academic achievement/failure across successive life stages (i.e., adolescence, emerging adulthood, young adulthood), resulting in adverse economic outcomes in young adulthood. The results indicate that early socioeconomic adversity and BMI-related genetics initiate additive, cascading, and cumulative processes through BMI and academic achievement leading to economic hardship after accounting for relevant demographic and contextual variables, including race/ethnicity. Importantly, the BMI-related polygenic score revealed a moderate genetic influence on youth BMI and academic achievement at each life stage. The findings highlight the need to inform longitudinal health and obesity research with molecular genetic information.

How Early Stressful Life Experiences Combine With Adolescents' Conjoint Health Risk Trajectories to Influence Cardiometabolic Disease Risk in Young Adulthood.

Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.

Temperament, socioeconomic adversity, and perinatal risk as related to preschoolers' BMI.

Disparities in childhood obesity necessitate identification of risk-protective and risk- augmenting factors for young children experiencing socioeconomic adversity born with perinatal risk. Temperamental reactivity is a biological marker of susceptibility to environmental characteristics. This study tested whether temperamental reactivity moderated the relation between socioeconomic risk and children's body mass index (BMI). This study examined 100 Head Start preschoolers (Mage = 4.07 years, SD = 0.56) with perinatal risk, defined as preterm birth (PT, <37 weeks gestation) or low birth weight (LBW, <2500g). Anthropometric measurements were collected from children and parents. Parents completed questionnaires on family level demographics and household food insecurity to create a cumulative socioeconomic risk variable. Parents also completed the Children's Behavior Questionnaire to assess preschoolers' temperamental reactivity. Results supported a differential susceptibility hypothesis such that preschoolers' temperamental reactivity significantly moderated the relation between socioeconomic risk and child BMI z-score (BMIz). Higher BMIz was observed in highly reactive children exposed to higher socioeconomic risk. Alternatively, lower exposure to socioeconomic risk was related to lower BMIz for highly reactive children. Findings suggest that highly reactive PT/LBW preschoolers are differentially susceptible to early socioeconomic adversity in a for better or for worse manner regarding BMIz. Thus, consideration of temperament as a marker of biological sensitivity to context may be necessary to inform obesity prevention for PT/LBW preschoolers from low-income families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Life Course Pathways From Childhood SES to Age-Related Declines in Kidney Function Across Adulthood

Age is a strong predictor of declines in kidney function across adulthood. Using data from 2,045 adults (ages 25-84) in the Midlife in the United States (MIDUS) study, we examined the life course pathways through which low parental education, through adult SES and body mass index (BMI), was associated with faster age-related declines in kidney function. Kidney function declines by 0.8 mL/min/1.73 m2 per year across adulthood. Lower parental education, through adult SES and BMI, was associated with higher kidney function among younger adults (Est = -1.61, SE = 0.62, 95%CI = -2.62, -0.60), but lower kidney function among older adults (Est = 0.93, SE = 0.51, 95%CI = 0.11, 1.79). The impact of early socioeconomic adversity on kidney function is initiated by kidney hyperfiltration in early adulthood and followed by faster declines and development into disease state in later adulthood.

Pathways linking early socioeconomic adversity to diverging profiles of romantic relationship dissolution in young adulthood.

Although studies on romantic relationships are abundant, cumulative experiences in intimate relationship dissolution (i.e., dissolution of cohabitation and marriage) during young adulthood is not yet completely understood. Using a nationally representative sample of 9,275 young adults, we investigated heterogeneity in timing and frequency of relationship dissolution during young adulthood, as well as its developmental precursors to dissolution. Results indicated four distinct relationship-dissolution classes that ranged from those who maintained stable romantic relationships to those who experienced multiple cohabitation dissolutions and divorces from ages 18 to 30 years. Early socioeconomic adversity predicted relationship-dissolution trajectories directly and indirectly through psychosociodemographic mechanisms in adolescence, including disrupted transitions to adulthood, conflict in dating relationships, and low levels of future orientation. Our findings highlight the heterogeneous romantic relationship trajectories of young adults and support the importance of the person-centered approach in elucidating developmental pathways underlying the longitudinal transitions in romantic relationships. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Supplemental Material for Pathways Linking Early Socioeconomic Adversity to Diverging Profiles of Romantic Relationship Dissolution in Young Adulthood

Supplemental Material for Pathways Linking Early Socioeconomic Adversity to Diverging Profiles of Romantic Relationship Dissolution in Young Adulthood

Early socioeconomic adversity and cardiometabolic risk in young adults: mediating roles of risky health lifestyle and depressive symptoms.

The study examined the mediating roles of risky health lifestyle and depressive symptoms in relation to childhood/adolescence adversity and young adult cardiometabolic risk with data from the National Longitudinal Study of Adolescent to Adult Health (n = 9421). Four classes of youth emerged from a latent class analysis with varying early adversity patterns: (a) both low disadvantaged SES and stressful experience (54.8%), (b) high disadvantaged SES and low stressful experience (31.0%), (c) low disadvantaged SES and high stressful experience (10.9%), and (d) both high disadvantaged SES and stressful experience (3.3%). Early adversity had multiple direct and indirect effects on CM risk for those experiencing SES-related adversities. Instead, early adversity generated mediational processes between adversity and CM risks through risky health lifestyle and depressive symptoms for those experiencing stressful experience. Implications for intervention when dealing with youths who have experienced multiple forms of early adversity are discussed.

Identifying diverse life transition patterns from adolescence to young adulthood: The influence of early socioeconomic context

The purposes of the present study are to investigate: (1) the heterogeneity in life transition patterns of youth from adolescence to young adulthood (ages 18–30) involving the timing and sequence of four transition events (college graduation, full-time employment, marriage, and parenthood), (2) the influence of early socioeconomic adversity on life transition patterns from adolescence to young adulthood, and (3) the influence of gender and race/ethnicity on these transition patterns. Using a multivariate discrete-time mixture survival model with a sample of 14,503 adolescents from the National Longitudinal Study of Adolescent to Adult Health (Add Health), the study identified four life transition patterns and found that early socioeconomic adversity shapes disrupted life transition patterns from adolescence to young adulthood. Gender and race/ethnicity differences are discussed. These results highlight the need for prevention and intervention programs that selectively target at-risk youth beginning in adolescence and continuing through subsequent transition periods.

Childhood socioeconomic circumstances and depressive symptom burden across 15years of follow-up during midlife: Study of Women's Health Across the Nation (SWAN).

Childhood socioeconomic disadvantage may contribute to adult depression. Understanding pathways by which early socioeconomic adversity may shape adult depression is important for identifying areas for intervention. Studies to date have focused on one potential pathway, adult socioeconomic status (SES), and assessed depression at only one or a few time points. Our aims were to examine (a) the association between childhood SES (low vs. high) and depressive symptom burden in midlife and (b) whether adult socioeconomic, psychosocial, and physical health characteristics are important pathways. Using annual data from a cohort of 1109 black and white US women recruited in 1996-1997, we evaluated the association between childhood SES and depressive symptom burden across 15years in midlife and whether adult characteristics-financial difficulty, lower education, stressful events, low social support, low role functioning, medical conditions, and bodily pain-mediated the association. Depressive symptom burden was estimated by calculating area under the curve of annual scores across 15years of the Center for Epidemiological Studies Depression (CES-D). In unadjusted models, low childhood SES was associated with greater depressive burden (P=0.0002). Each hypothesized mediator, individually, did not reduce the association. However, when five of the hypothesized mediators were included together in the same analysis, they explained more than two thirds of the association between childhood SES and depressive symptom burden reducing the P value for childhood SES to non-significance (P=0.20). These results suggest that childhood SES influences midlife depressive symptom burden through a cluster of economic stress, limited social resources, and physical symptoms in adulthood.

Genetic moderation of multiple pathways linking early cumulative socioeconomic adversity and young adults' cardiometabolic disease risk.

Recent research suggests that psychosocial resources and life stressors are mediating pathways explaining socioeconomic variation in young adults' health risks. However, less research has examined both these pathways simultaneously and their genetic moderation. A nationally representative sample of 11,030 respondents with prospective data collected over 13 years from the National Study of Adolescent to Adult Health was examined. First, the association between early cumulative socioeconomic adversity and young adults' (ages 25-34) cardiometabolic disease risk, as measured by 10 biomarkers, through psychosocial resources (educational attainment) and life stressors (accelerated transition to adulthood) was examined. Second, moderation of these pathways by the serotonin transporter linked polymorphic region gene (5-HTTLPR) was examined. There was evidence for the association between early socioeconomic adversity and young adults' cardiometabolic disease risk directly and indirectly through educational attainment and accelerated transitions. These direct and mediating pathways were amplified by the 5-HTTLPR polymorphism. These findings elucidate how early adversity can have an enduring influence on young adults' cardiometabolic disease risk directly and indirectly through psychosocial resources and life stressors and their genetic moderation. This information suggests that effective intervention and prevention programs should focus on early adversity, youth educational attainment, and their transition to young adulthood.

Out of harm's way: Secure versus insecure-disorganized attachment predicts less adolescent risk taking related to childhood poverty.

Although some risk taking in adolescence is normative, evidence suggests that adolescents raised in conditions of socioeconomic disadvantage are disproportionately burdened with risk taking and its negative consequences. Using longitudinal data from the NICHD Study of Early Child Care and Youth Development, we investigated quality of the early caregiving environment as a potential prospective buffer against the long-term association between childhood poverty and adolescent risk taking. Multicategorical moderation model results indicated that if raised in poverty across age 1-54 months (average family income to needs ratio ≤ 1.02), relative to affluence (income to needs ratio ≥ 6.16), adolescents with histories of secure attachment to caregivers exhibited two times the number of risk behaviors at age 15, whereas adolescents with insecure-disorganized histories exhibited nearly five times the number of risk behaviors. Both early family economic hardship and history of insecure-disorganized attachment remained significant predictors of increased adolescent risk taking, alongside the interactive effect. Probing the interaction's region of significance revealed that history of secure (vs. insecure-disorganized) attachment is associated with protective reductions in risk taking below a family income to needs ratio of 2.24, or about 220% poverty level. Findings support a diathesis-stress model in which children with secure attachment histories are less deleteriously impacted by early socioeconomic adversity than their insecure-disorganized peers.

Towards a Heuristic Research Model Linking Early Socioeconomic Adversity and Youth Cumulative Disease Risk: An Integrative Review

This integrative review draws on previous empirical and theoretical work across multiple research traditions, including psychology, sociology, and neurology, to create a framework detailing pathways linking early socioeconomic adversity in childhood and adolescence to subsequent disease risk later in adolescence and young adulthood. A comprehensive search ultimately led to the socioeconomic adversity and disease risk model for youth, which is a heuristic research framework detailing four overarching pathways focused on early biological/genetic vulnerability, physiological responses (comprised of stress responses and hormonal activity), psychosocial resource trajectories, and behavioral and mental health trajectories as well as potential modifiers of these pathways. Other central constructs include brain development/neuroplasticity and adolescent life stressors. The heuristic research framework calls for an integrated perspective taking a long-view over early life course to explain cumulative physical disease risk by combining knowledge from developmental, social, neurocognitive, and biological sciences.

Disentangling the Influence of Socioeconomic Risks on Children's Early Self-Control.

ObjectivePrevious studies have shown that individual differences in self‐control emerge early in childhood and predict a range of important outcomes throughout childhood and adulthood. There is, however, less knowledge about the social origins of self‐control, including the mechanisms by which early socioeconomic adversity may lead to lower levels of self‐control. This study aimed to extend understanding of the link between socioeconomic adversity and self‐control by (a) testing which individual aspects of socioeconomic risk uniquely predict lower self‐control; (b) testing whether objective socioeconomic risk operates independently of, or via, subjective parental stress; and (c) examining the interplay of socioeconomic risk factors and individual differences in children's temperament as predictors of early self‐control.MethodData were from a UK population birth cohort of 18,552 children born in 2000 and 2001.ResultsMultiple individual socioeconomic risk factors have independent associations with children's self‐control, including low parental education, income, and occupational class; insecure housing tenure; and younger parenthood. Results point to independent additive effects of exposure to objective and subjective risk. There was evidence of mothers' subjective stress partially mediating objective socioeconomic risks but only weak evidence of hypothesized interaction effects between temperament and socioeconomic risk.ConclusionsResults were consistent with additive risk and bioecological perspectives.

Life-course social and economic circumstances, gender, and resilience in older adults: The longitudinal International Mobility in Aging Study (IMIAS)

Although early socioeconomic adversity is associated with poorer function and health in adulthood, those who are able to adapt positively to such risks and threats develop a resilience that may ameliorate harm. Predictors of resilience have been examined in children, however exploring the relationship between life-course events, lived environments and current resilience among older adults across countries is novel. We specifically studied how childhood social and/or economic adversity and current socioeconomic resources were associated with resilience in 2000 community dwelling older men and women in Canada, Colombia, Brazil and Albania. The longitudinal International Mobility in Aging Study (IMIAS) collected information in 2012 and 2014 on childhood adversity, current income sufficiency social support and social engagement, and resilience (Wagnild Resilience Scale RS-14). Resilience levels were moderately high, and similar among women and men. Early social adversity predicted later resilience for some, with women but not men adapting positively. In contrast there was no bouncing back from early economic adversity. Current social engagement aligned with resilience (women only) as did social support from children (for women) and friends (for men). Partner support was of no advantage to either. Among men economic circumstances were stronger correlates of resilience while for women social circumstances were primary. The impact of site on resilience suggested that cultural norms and values have an independent effect on resilience of their populations, with strong and positive social ties more typical of Latin America than Canada appearing to offset lower absolute incomes. These findings are of importance because resilience is dynamic, can be fostered across the lifespan and is generally associated with greater health. Understanding which social assets and resources can be reinforced to build individual resilience offers a means for decreasing the harms of social and economic adversity.