Health Outcomes In Later Life Research Articles

Common genetic variants with fetal effects on birth weight are enriched for proximity to genes implicated in rare developmental disorders.

Birth weight is an important factor in newborn survival; both low and high birth weights are associated with adverse later-life health outcomes. Genome-wide association studies (GWAS) have identified 190 loci associated with maternal or fetal effects on birth weight. Knowledge of the underlying causal genes is crucial to understand how these loci influence birth weight and the links between infant and adult morbidity. Numerous monogenic developmental syndromes are associated with birth weights at the extreme ends of the distribution. Genes implicated in those syndromes may provide valuable information to prioritize candidate genes at the GWAS loci. We examined the proximity of genes implicated in developmental disorders (DDs) to birth weight GWAS loci using simulations to test whether they fall disproportionately close to the GWAS loci. We found birth weight GWAS single nucleotide polymorphisms (SNPs) fall closer to such genes than expected both when the DD gene is the nearest gene to the birth weight SNP and also when examining all genes within 258 kb of the SNP. This enrichment was driven by genes causing monogenic DDs with dominant modes of inheritance. We found examples of SNPs in the intron of one gene marking plausible effects via different nearby genes, highlighting the closest gene to the SNP not necessarily being the functionally relevant gene. This is the first application of this approach to birth weight, which has helped identify GWAS loci likely to have direct fetal effects on birth weight, which could not previously be classified as fetal or maternal owing to insufficient statistical power.

Late-career unemployment and risk of frailty among older adults in Taiwan: An 8-year population-based cohort study.

To evaluate whether late-career unemployment is associated with increased physical frailty among older adults in Taiwan by the design of a population-based cohort study. Data were retrieved from the Taiwan Longitudinal Study on Aging. The study examined data from the period 1999 to 2007. A total of 652 subjects were included in the final analysis, and they were categorized as normally employed or unemployed depending on their employment status in 1999. Frailty was defined using the Fried criteria. Multiple confounding factors were adjusted in a multilevel analysis. The average age of the participants in 1999 was 59.0 years. A total of 491 participants were normally employed, and 161 participants were unemployed. After adjustment for gender, age, level of education, income, marital status, and number of chronic diseases, late-career unemployment was associated with increased frailty [odds ratio (OR) = 1.61; 95% confidence interval (CI) = 1.00-2.59]. The risk of developing frailty was higher for participants who were unemployed during late career and had poor self-rated health [OR = 3.54; 95% CI = 1.37-9.20]. Late-career unemployment is associated with increased frailty, especially for those who also have poor self-rated health. Older adults should be encouraged to maintain normal employment during the later stages of their career before retirement. Employers should apply strategies to prevent possible late-career unemployment, and the government should provide resources and help to unemployed older workers so that they can minimize poor health outcomes in late life. Geriatr Gerontol Int 2021; 21: 353-358.

Life Employment Histories in Middle Age and Their Association With Health Outcomes in Later Life: A Sequence Analysis

Despite consistent evidence on the negative effect of precarious employment on health, little is known about the dynamic pattern of employment over the life course on later year health. Using the longitudinal data (1-18 waves) from the Korean Labor & Income Panel Study (KLIPS) (n=1,705), this study aimed to (1) identify long term change patterns of employment in two middle-age groups (early middle-aged: 40-49 / late middle-aged: 50-59), (2) examine the association between the patterns and self-rated health in old age. We apply sequence analysis with 18 years of working status and conducted regression health outcomes in the 18th wave. The result of sequence analysis found the differential employment patterns: among the early middle-aged, five patterns were identified consistently full-time, consistently not- working, transit to self-employed, mixed pattern, retired. Among the late middle-aged, five patterns were identified: consistently full time, mixed pattern, consistently retired, transit to not- working, consistently not working. Regression results indicated a negative association between precarious employment history and health in later years: Among the early middle-aged, members in the “consistently full-time” were likely to have better health compared to “transit to self-employed”. Among the later middle-aged, “retired” and “transit to not –working” were likely to have better health compared to “mixed pattern group”. The findings suggest the importance of employment history in middle age to predict the health outcome in later life. Policies to support experiencing precarious or self-employment are needed to prevent health disparity in later life.

Relationship Quality and Depressive Symptoms Among Very Old Parents and Their Older Children in South Korea

Research has consistently reported the association between intergenerational relationship quality and mental health outcomes in later life. However, few studies have examined the link among very old parents and their older children, and even fewer studies investigated whether the relationship quality matters similarly to parents and children. Employing a dyadic approach, this study examined how one’s own and partner’s perceptions of relationship quality (i.e., support and conflict) are associated with depressive symptoms among very old parents and their children. Data from 105 dyads of parents (age 81-97; M = 87.92, SD = 2.80) and their children (age 65-72; M = 65.87, SD = 1.23) in South Korea were used. Results showed that parents tended to report significantly higher levels of intergenerational support and lower levels of intergenerational conflict, compared to their children. Regarding the actor effects of relationship quality, one’s own perceptions of intergenerational conflict were positively associated with depressive symptoms for both parents (β = 0.26, p < .01) and children (β = 0.37, p < .001), whereas intergenerational support was not significant. In terms of the partner effect, intergenerational support (reported by parents) was negatively related to depressive symptoms only for children (β = -0.21, p < .01), but the partner effect of conflict was not significant. The findings highlight the centrality of perceptions of intergenerational relationship in understanding well-being in later life. Further, children’s depressive symptoms were susceptible to how their parents view the relationship. Findings were discussed in the context of Intergenerational Stake Theory.

Which Contextual Features Predict Physiological Stress Reactivity in Midlife to Late Life?

Chronic stress creates vulnerability to adverse mental and physical health outcomes in later life. While claims about the negative effects of stress on health are primarily based on self-report, it is unclear how subjective stress measures (chronic or perceived stress) and other environmental or individual characteristics (neighborhood, social and health behaviors) relate to physiological stress response. This study examines which contextual features contribute to differences in physiological stress reactivity among adults at risk of type II diabetes (Richmond Stress and Sugar Study, n=125, aged 40-70). Psycho-social stress was induced via Trier Social Stress Test. Using advanced selection methods, we simultaneously explore multiple predictors and illustrate how different sets of risk and protective factors contribute to normal or abnormal stress reactivity profiles. Preliminary results suggest that the top five important predictors are education, contact with friends, perceived stress, ruminative coping, and sedentary behavior. Implications for research and targeted interventions are discussed.

Sex Differences in Energetic Cost of Walking and Later-Life Function and Physical Activity Patterns

Aerobic fitness is a strong predictor of functional independence with aging. Variability in aerobic fitness is due, in part, to the efficiency of the movement of body mass while ambulating [energetic cost of walking (ECoW)]. ECoW may serve as a low burden measure of fitness compared to volitional treadmill tests. We assessed the predictive ability of ECoW with later-life function and physical activity participation in healthy adults. N=75 (age = 54.7 +/- 9.2; 52% female) completed a treadmill test with indirect calorimetry, during which time a warm-up of 1.5 mph at 0% grade was uniform. ECoW was quantified as steady state volume of oxygen consumption (ml/kg/min) subtracted by the calculated metabolic cost of walking at given speed and grade (=7.5 ml/kg/min). Later-life (median=9 years follow-up) function was assessed using the SF-36 physical functioning subscale, and the Baecke questionnaire for physical activity. Mean EcoW was similar to calculated cost (difference = -0.14 ml/kg/min) but had large variation (SD = 2.7; range = -4.4 to +17 ml/kg/min). In females, higher ECoW was predictive of better later-life function (b=1.9; p=0.04) and higher physical activity levels (b=0.09; p=0.001). In males, lower ECoW was predictive of higher physical activity levels only (b=-0.04; p=0.01). All models controlled for % body fat, age, and comorbidities. Surprisingly, in females, higher ECoW was associated with better later-life health outcomes. We hypothesize that this phenomenon may be similar to the obesity paradox, in that relatively higher non-metabolic tissue in females may serve as a stimulus for muscle and functional preservation.

Defining the Personal Determinants of Health for Older Adults

Social Determinants of Health (SDOH) are defined as the broad community-scale conditions and factors shaping daily life. Meanwhile, less is known about the personal, individual-level characteristics impacting health outcomes. These have not been defined as a construct, leaving a gap in overall understanding of the resources that shape healthy and successful aging. Our primary purpose is to propose and define a new construct encompassing critical personal resources to be known as the Personal Determinants of Health (PDOH), built on resilience as a key strength later in life and supported by factors that buffer challenges and declining health. A literature search was conducted to streamline the scope of this review, with key terms determined to identify relevant publications; common databases and resources were utilized. Search strategies failed to identify a standard definition for Personal Determinants of Health as a construct, nor does this term exist regarding applied initiatives with older adults. Thus, a clear opportunity exists to establish PDOH as a unique construct. Despite evidence that individual characteristics impact late-life health outcomes, these key personal resources have not been established as a separate construct. Thus, we propose to define PDOH with a foundation of resilience supported by selected personal resources. Establishing this new construct will be critical in designing initiatives to support older adults and improve their health outcomes.

Medicaid expansion and neonatal outcomes in Oregon

Low-income women disproportionately experience preventable, adverse neonatal outcomes. Prior to the Affordable Care Act (ACA) Medicaid expansion, many low-income women became eligible for coverage only after becoming pregnant, reducing their access to healthcare before pregnancy and creating discontinuities in care that may delay Medicaid enrollment. The objective of this study was to examine the impact of the ACA Medicaid expansion on neonatal outcomes among low-income populations in Oregon. We used linked Oregon birth certificate and Medicaid data from 2008-2016 to identify control and policy groups of women who gave birth both before and after implementation of the ACA Medicaid expansion (n = 21 204 births to N = 10 602 women). We conducted a difference-in-differences analysis of the effect of Medicaid expansion on preterm birth, low birthweight (LBW), neonatal intensive care unit (NICU) admissions, and neonatal mortality. We found policy effects on reducing LBW (interaction aOR = 0.71, 95% CI: 0.57-0.90) and preterm birth (interaction aOR 0.77, 95% CI: 0.62 = 0.96) but not on NICU admissions or neonatal mortality. This study provides evidence that expanding Medicaid coverage may have positive effects on LBW and preterm birth, which could lead to important long-term impacts on childhood and later-life health outcomes. States that have not expanded their Medicaid programs might improve neonatal outcomes among low-income populations by extending insurance coverage to low-income adults.

Identifying environmental exposure profiles associated with timing of menarche: A two-step machine learning approach to examine multiple environmental exposures

BackgroundVariation in the timing of menarche has been linked with adverse health outcomes in later life. There is evidence that exposure to hormonally active agents (or endocrine disrupting chemicals; EDCs) during childhood may play a role in accelerating or delaying menarche. The goal of this study was to generate hypotheses on the relationship between exposure to multiple EDCs and timing of menarche by applying a two-stage machine learning approach. MethodsWe used data from the National Health and Nutrition Examination Survey (NHANES) for years 2005–2008. Data were analyzed for 229 female participants 12–16 years of age who had blood and urine biomarker measures of 41 environmental exposures, all with >70% above limit of detection, in seven classes of chemicals. We modeled risk for earlier menarche (<12 years of age vs older) with exposure biomarkers. We applied a two-stage approach consisting of a random forest (RF) to identify important exposure combinations associated with timing of menarche followed by multivariable modified Poisson regression to quantify associations between exposure profiles (“combinations”) and timing of menarche. ResultsRF identified urinary concentrations of monoethylhexyl phthalate (MEHP) as the most important feature in partitioning girls into homogenous subgroups followed by bisphenol A (BPA) and 2,4-dichlorophenol (2,4-DCP). In this first stage, we identified 11 distinct exposure biomarker profiles, containing five different classes of EDCs associated with earlier menarche. MEHP appeared in all 11 exposure biomarker profiles and phenols appeared in five. Using these profiles in the second-stage of analysis, we found a relationship between lower MEHP and earlier menarche (MEHP ≤ 2.36 ng/mL vs >2.36 ng/mL: adjusted PR = 1.36, 95% CI: 1.02, 1.80). Combinations of lower MEHP with benzophenone-3, 2,4-DCP, and BPA had similar associations with earlier menarche, though slightly weaker in those smaller subgroups. For girls not having lower MEHP, exposure profiles included other biomarkers (BPA, enterodiol, monobenzyl phthalate, triclosan, and 1-hydroxypyrene); these showed largely null associations in the second-stage analysis. Adjustment for covariates did not materially change the estimates or CIs of these models. We observed weak or null effect estimates for some exposure biomarker profiles and relevant profiles consisted of no more than two EDCs, possibly due to small sample sizes in subgroups. ConclusionA two-stage approach incorporating machine learning was able to identify interpretable combinations of biomarkers in relation to timing of menarche; these should be further explored in prospective studies. Machine learning methods can serve as a valuable tool to identify patterns within data and generate hypotheses that can be investigated within future, targeted analyses.

DNA methylation in infants with low and high body fatness

BackgroundBirth weight is determined by the interplay between infant genetics and the intrauterine environment and is associated with several health outcomes in later life. Many studies have reported an association between birth weight and DNA methylation in infants and suggest that altered epigenetics may underlie birthweight-associated health outcomes. However, birth weight is a relatively nonspecific measure of fetal growth and consists of fat mass and fat-free mass which may have different effects on health outcomes which motivates studies of infant body composition and DNA methylation. Here, we combined genome-wide DNA methylation profiling of buccal cells from 47 full-term one-week old infants with accurate measurements of infant fat mass and fat-free mass using air-displacement plethysmography.ResultsNo significant association was found between DNA methylation in infant buccal cells and infant body composition. Moreover, no association between infant DNA methylation and parental body composition or indicators of maternal glucose metabolism were found.ConclusionsDespite accurate measures of body composition, we did not identify any associations between infant body fatness and DNA methylation. These results are consistent with recent studies that generally have identified only weak associations between DNA methylation and birthweight. Although our results should be confirmed by additional larger studies, our findings may suggest that differences in DNA methylation between individuals with low and high body fatness may be established later in childhood.

Birth signalling hormones and the developmental consequences of caesarean delivery.

Rates of delivery by caesarean section (CS) are increasing around the globe and, although several epidemiological associations have already been observed between CS and health outcomes in later life, more are sure to be discovered as this practice continues to gain popularity. The components of vaginal delivery that protect offspring from the negative consequences of CS delivery in later life are currently unknown, although much attention to date has focused on differences in microbial colonisation. Here, we present the case that differing hormonal experiences at birth may also contribute to the neurodevelopmental consequences of CS delivery. Levels of each of the 'birth signalling hormones' (oxytocin, arginine vasopressin, epinephrine, norepinephrine and the glucocorticoids) are lower following CS compared to vaginal delivery, and there is substantial evidence for each that manipulations in early life results in long-term neurodevelopmental consequences. We draw from the research traditions of neuroendocrinology and developmental psychobiology to suggest that the perinatal period is a sensitive period, during which hormones achieve organisational effects. Furthermore, there is much to be learned from research on developmental programming by early-life stress that may inform research on CS, as a result of shared neuroendocrine mechanisms at work. We compare and contrast the effects of early-life stress with those of CS delivery and propose new avenues of research based on the links between the two bodies of literature. The research conducted to date suggests that the differences in hormone signalling seen in CS neonates may produce long-term neurodevelopmental consequences.

Childhood exposure to hunger: associations with health outcomes in later life and epigenetic markers.

Aim: To assess associations of early exposure to hunger with depressive symptoms and cardiovascular disease (CVD) and to investigate possible epigenetic pathways. Patients & methods: Data were based on aGerman population-based cohort of older adults (n=9631). Regression models were performed for health outcomes in later life. An epigenome-wide association study for early-life exposure to hunger was performed in a subgroup (n=2221) with whole blood DNA methylation data. Results: Childhood exposure to hunger was associated with CVD and depressive symptoms in later life. Prenatal or infant exposure was strongly associated with depressive symptoms. No CpG reached epigenome-wide significance after multiple testing correction. Conclusion: Childhood hunger is a risk factor for depressive symptoms and CVD at older age. DNA methylation could not explain this association.

Female Sport Participation Effect on Long-Term Health-Related Quality of Life.

Female participation in sport has grown substantially over the last 4 decades. We investigated the association between sports participation and (1) later-life health outcomes and (2) later-life quality-of-life (QoL) measures among female college alumni. We conducted a cross-sectional study of female alumni between the ages of 40 and 70 years. Participants completed a questionnaire that included QoL measures assessing general health, negative consequences of alcohol use, mental health, and other self-reported health outcomes. We divided alumni into athletes and nonathletes. Between-group comparisons of health outcomes were adjusted for age; QoL measures were adjusted for age, exercise habits, cigarette smoking, alcohol use, and comorbidities. Questionnaires were sent to 47 836 alumni, 3702 (8%) responded. Forty-four percent of female respondents participated in collegiate sports. After adjusting for age, female respondents who participated in collegiate sports were more likely to exercise >3×/week (61.8% vs 50.2%; P ≤ 0.001), view themselves in good/great health (91% vs 85%; P < 0.001), and less likely to have ever smoked (13.6% vs 25.3%; P ≤ 0.001) or used recreational drugs (7.5% vs 9.5%; P = 0.018). A smaller proportion of female athletes reported hypertension (5.5% vs 13.5%; P ≤ 0.001), high cholesterol (9.9% vs 17.0%; P < 0.001), and obesity (3.1% vs 6.8%; P = 0.001) compared with nonathletes. Participation in sports was, however, associated with decreased mobility (R = 0.1826; P = 0.002) and increased anxiety (R = 0.039; P = 0.016) QoL scores. Sports participation for female collegiate athletes was associated with mostly positive health outcomes, but also with lower mobility and increased anxiety QoL scores.

Associations ofPerfluoroalkyl Substances withIncident Natural Menopause: the Study of Women’s Health Across the Nation

Context: Previous epidemiologic studies of per- and polyfluoroalkyl substances (PFAS) and menopausal timing conducted in cross-sectional settings were limited by reverse causation because PFAS serum concentrations increase after menopause.Objectives: To investigate associations between PFAS serum concentrations and incident natural menopause.Design and Setting: A prospective cohort of midlife women, the Study of Women’s Health Across the Nation, from 1999 to 2017.Participants: 1120 multi-racial/ethnic premenopausal women (White, Black, Chinese and Japanese) aged 45-56 years in 1999-2000.Methods: Serum PFAS concentrations were measured using an online solid phase extraction-high performance liquid chromatography-isotope dilution-tandem mass spectrometry. The final menstrual period was determined during the annual follow-up visits. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: Participants contributed 5466 person-years of follow-up, and 578 had incident natural menopause. Compared to the lowest tertile, women at the highest tertile of baseline serum concentrations had adjusted HR for natural menopause of 1.26 (95%CI: 1.02-1.57) for n-perfluorooctane sulfonic acid (n-PFOS) (Ptrend=0.03), 1.27 (95%CI: 1.01-1.59) for branched-PFOS (Ptrend=0.03), and 1.31 (95%CI: 1.04-1.65) for n-perfluorooctanoic acid (Ptrend=0.01). Women were classified into four clusters based on their overall PFAS concentrations as mixtures: low, low-medium, medium-high, and high. Compared to the low cluster, the high cluster had a HR of 1.63 (95% CI: 1.44-1.84), which is interpreted as 2.0 years earlier experience of natural menopause.Conclusion: This study suggests that select PFAS serum concentrations are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.

Adverse childhood experiences, DNA methylation age acceleration, and cortisol in UK children: a prospective population-based cohort study

Epigenetic mechanisms may partly explain the persistent effects of adverse childhood experiences (ACEs) on health outcomes in later life. DNA methylation can predict chronological age, and advanced methylation-predicted age beyond chronological age (DNA methylation age acceleration) is associated with ACEs, adverse mental and physical health, and elevated diurnal and baseline salivary cortisol. Childhood adversity is also associated with dysregulation of the hypothalamic-pituitary-adrenal axis, which produces the neuroendocrine hormone cortisol. It remains unknown whether these associations are specific to certain types of adversity. Herein, we investigate the associations of ACEs with DNA methylation age acceleration and plasma cortisol in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. In this study of the children in ALSPAC, we used multiple linear regression to examine associations of cumulative exposure to ACE, as well as exposure to ten individual types of ACEs, with Horvath-estimated DNA methylation age acceleration and with baseline plasma cortisol. The ten ACEs were those included in the World Health Organization’s ACE International Questionnaire. Data on ACEs were prospectively collected from age 0–14 years. DNA methylation age acceleration and plasma cortisol were measured at mean 17.1 years and 15.5 years, respectively. We included 974 UK children in the present study. Exposure to four or more ACEs compared to zero was associated with DNA methylation age acceleration in girls (β, 95% CI = 1.65, 0.25 to 3.04 years) but not in boys (β, 95% CI = − 0.11, − 1.48 to 1.26 years). Also, in girls, emotional abuse and physical abuse were each associated with DNA methylation age acceleration (β, 95% CI = 1.20, 0.15 to 2.26 years and β, 95% CI = 1.22, 0.06 to 2.38 years, respectively). No other ACEs were associated with accelerated DNA methylation age in either sex. Associations were also null between ACE and cortisol, and cortisol and DNA methylation age acceleration. In this prospective population-based study of UK children, cumulative ACE exposure, emotional abuse, and physical abuse between age 0 and 14 years were each associated with Horvath-estimated DNA methylation age acceleration at age 17 years in girls but not in boys.

The Relationship Between Childhood Circumstances and Late Life Physical and Mental Health: The Role of Adult Socioeconomic Status.

Socioeconomic status and health in childhood are linked to health outcomes in later life. Health outcomes may also be shaped by socioeconomic circumstances in adulthood and later life. This paper examined the relationship between childhood conditions and later life health and tested whether this relationship was mediated by later life economic living standards. Data from a longitudinal study of aging was combined with retrospective life history data from 787 participants from the New Zealand Health, Work and Retirement Study. Significant relationships were found between childhood conditions and later life health. These relationships were mediated by economic living standards in older age, but the partial direct effect of childhood conditions on health found in early older age became fully meditated 10 years later. While childhood circumstances are part of this complex relationship, socioeconomic conditions in later life are vital to ensuring ongoing health into older age.

Lingering Impact of Starting Working Life During a Recession: Health Outcomes of Survivors of the "Employment Ice Age" (1993-2004) in Japan.

BackgroundA growing amount of evidence demonstrates the adverse impacts of economic downturns on population health. However, the extent to which the macroeconomic conditions at labor market entry affect health outcomes in later life remains relatively understudied. This study focused on the health outcomes of the cohort who entered the labor market during the “employment ice age” (EIA; 1993–2004) in Japan, when young people had difficulty finding jobs after graduating from college or high school.MethodsWe used repeated cross-sectional data (N = 3,054,782; 1,500,618 men and 1,554,164 women) obtained from an 11-wave population-based nationwide survey conducted every 3 years from 1986 through 2016. We considered three health outcomes: being in hospital, subjective symptoms, and self-rated health (SRH). We employed two types of statistical analyses: an age-period-cohort (APC) analysis, which controlled for age and period (wave) effects, and a difference-in-differences (DiD) analysis, in which the EIA experience was regarded as a treatment.ResultsThe APC analysis confirmed the relative disadvantage of the EIA cohort for all three outcomes; for instance, the odds ratio of poor SRH for the EIA cohort was 1.29 (95% confidence interval [CI], 1.21–1.38) for men and 1.25 (95% CI, 1.17–1.34) for women. The DiD analysis confirmed the robustness of these results, especially for men.ConclusionsThe results underscored the lingering impact of the macroeconomic conditions at labor market entry on health outcomes in later life in Japan.

“Not performing worse but feeling older !” the negative effect of the induction of a negative aging stereotype

The present research investigated the effect of the induction of a negative stereotype on older adults’ performance during an endurance task, and how this stereotype influenced older adults’ subjective age. Thirty-four old women were randomly assigned to one of the two conditions: a negative stereotype condition and a nullified-stereotype condition. They performed an endurance task consisting of maintaining 30% of their maximal strength, as long as possible. Then, they answered a questionnaire including subjective age measurement. Contrary to expectations, the induction of the negative stereotype did not influence participants’ endurance performance. However, participants in the negative stereotype condition felt older than participants in the nullified-stereotype condition. As subjective age is relevant to late-life health outcomes, such as walking speed or mortality risk, it seems necessary to implement some strategies to decrease the negative effect of the negative stereotype on subjective age.

Comparison Between Accuracy of Sonographic Fetal Weight Estimation Versus Actual Baby Weight at the Time of Birth

Estimation of fetal weight before the birth is a key to plan a safe mode of delivery. It helps to overcome many health outcomes in later life.

Climate exposures and child undernutrition: Evidence from Indonesia.

Global climate change has the potential to disrupt agricultural systems, undermine household socioeconomic status, and shape the prevalence and distribution of diseases. Each of these changes may influence children's nutritional status, which is sensitive to food availability, access, and utilization, and which may have lasting consequences for later-life health and socioeconomic outcomes. This paper contributes to the emerging literature on climate and child health by studying the effects of temperature and precipitation exposures on children's height and weight in Indonesia. Drawing on five rounds of the Indonesian Family Life Survey (IFLS) implemented between 1993 and 2015, we estimate fixed-effects regression models of height-for-age (HFA) and weight-for-height (WFH) among samples of children ages 24-59 months and 0-23 months, respectively. We test for heterogeneity in these effects across sub-populations expected to vary in their vulnerability. Results show that delays in monsoon onset are consistently associated with worse child health outcomes. Delays in monsoon onset during the prenatal period are associated with reduced child height among children age 2-4 years. The weight of young (<2 years) children is adversely affected by delays in the most recent monsoon season, and this relationship is particularly strong among residents of Java. Overall, our results underline the need for interventions that protect children's nutrition and underlying health against the effects of climate change.