Parental Socioeconomic Position Research Articles

Early life predictors of midlife allostatic load: A prospective cohort study.

BackgroundAllostatic load has been suggested as a pathway through which experiences become biologically embedded to influence health. Research on childhood predictors of allostatic load has focused on socioeconomic and psychosocial exposures, while few studies include prospective measures of biomedical exposures. Further, findings on sex differences in the association of childhood predictors with various health outcomes related to allostatic load are ambiguous.AimsTo examine the influence of early life biomedical and social factors in the first year of life on midlife allostatic load, assessing potential sex differences.MethodsThis prospective cohort study includes early life information collected at birth and a one year examination for 1,648 members of the Copenhagen Perinatal Cohort who also participated in the Copenhagen Aging and Midlife Biobank study (aged 49–52 years, 56% women). Allostatic load based on 14 biomarkers was selected as a measure of midlife health status. Early life factors were categorized as predominantly biomedical or social, and their associations with midlife allostatic load were examined in domain-specific and combined sex-stratified multiple regression models.ResultsThe biomedical factors model explained 6.6% of the variance in midlife allostatic load in men and 6.7% in women, while the social model explained 4.1% of the variance in men and 7.3% in women. For both sexes, parental socioeconomic position at one year and maternal BMI significantly predicted midlife allostatic load in a model containing all early life factors. For women, additional significant predictors were complications at birth, birth weight and not living with parents at one year.ConclusionThe results confirm an association of lower childhood socioeconomic position with higher adult allostatic load while demonstrating the importance of other prenatal and early life exposures and highlighting potential sex differences.

Parental alcohol problems and socioeconomic differences in emotional symptoms among young people

Introduction Children of parents with alcohol problems have been found to be at increased risk of adverse mental health outcomes. The aim was to test if there is a social gradient in emotional symptoms among young people with parental alcohol problems. We hypothesized that the shared burden of parental alcohol problems and low socioeconomic position would be associated with higher odds of frequent emotional symptoms. Methods Data came from Danish National Youth Study 2014, a web-based national survey, merged with register-data on family socioeconomic position. Participants consisted of 68,623 high school and vocational school students. Multilevel logistic regression models (nesting participants within 131 schools) were used to assess the association between perceived parental alcohol problems and frequent emotional symptom and effect-modification by financial strains in the family, family equivalent income or parental educational level. All analyses were adjusted for age, sex, education, immigration status, and cohabitation with parents. Results A higher proportion of young people from low socioeconomic position reported parental alcohol problems and young people with parental alcohol problems had higher odds of frequent emotional symptoms (OR = 1.50 95% CI: 1.41–1.60]), as compared to those without parental alcohol problems. Odds ratios for emotional symptoms were similar in strata of financial strains in the family; young people with parental alcohol problems and no financial strains in the family had an OR of 1.37 (95%CI: 1.26–1.49) and 1.33 (95% CI: 1.20–1.49) in those with financial strains in the family (P for interaction = 0.358). Same pattern was seen for parental educational level and family equivalent income. Conclusion Parental alcohol problems and low socioeconomic position were associated with higher odds of frequent emotional symptoms, but no sign of effect-modification by socioeconomic position was found.

Inequality, familial aggregation, and risk prediction of caries in Siblings. A natiowide study of Danish adolescents

Introduction Sibling designs in assessing familial aggregation and risk prediction of dental caries have been largely unutilized. This large-scale investigation evaluated the robustness of parental socioeconomic position (SEP) as a cardinal determinant of caries experience by appraising it at the family level. Moreover, sibling-specific aggregation of caries within families and the discriminant ability of sibling caries in predicting co-sibling caries was ascertained. Methods A nationwide, register-based cross-sectional study was conducted on Danish adolescent siblings (n = 23,847 sibling pairs; index siblings/probands: all 15-year-olds in 2003; co-siblings: biological siblings born to the same mother within ± 3 years). Clinical (caries) data for each study subject were acquired from the national dental database (Sundhedsstyrelsens Centrale Odontologiske Register [SCOR]). Data on social variables, namely, parental SEP (parental education, income, and occupation), ethnicity, age/birth order, gender, and household type, were compiled from administrative registers at Statistics Denmark (e.g., the Danish population, education, labor market affiliation, and income and transfer payments registers). The social gradient in the magnitude of caries experience among the index- and co-siblings was estimated using negative binomial regression and generalized estimating equations taking into account family level clustering. Familial aggregation of caries was ascertained using probandwise concordance rates and adjusted pairwise odds ratios (PORs) from alternating logistic regressions. In order to determine the discriminant ability of proband caries and that of the other study covariates to effectively predict the absence or presence of caries in a sibling, a classification and regression tree (CART) analysis was undertaken. The predictive power of the CART models was evaluated using the area under the Receiver Operating Characteristic curve (AUROC) statistic. Results The prevalence of dental caries experience in the overall study population was 73.6% (index siblings 74.3%, co-siblings 72.9%). Conspicuous social patterning of caries was observed in both the index- and co-sibling populations even after adjustment for all study covariates. Significant sibling-specific familial aggregation of caries was observed, which varied in a stepwise graded fashion across the social hierarchy. Overall, 70.6% of sibling pairs were concordant in terms of their caries experience (caries 58.9%, caries-free 11.7%). Co-siblings of affected probands had 3.9 times (95% CI: 3.65–4.18) higher (adjusted) odds of having caries compared to those with caries-free siblings. This sibling similarity was further amplified in those with relative socioeconomic disadvantage (e.g., the adjusted PORs varied from 3.39 [95% CI: 3.04–3.77] in the highest to 5.47 [95% CI: 4.36–6.86] in the lowest parental education category). AUROCs from the CART models ranged from 0.7–0.82, indicating useful to excellent overall predictive power of the models. These models revealed sibling (proband) caries experience to be the single-most important risk predictor of caries in individuals (co-siblings), with the results indicating that caries could be expected in ≥ 84% of siblings of adolescents with 3 or more caries-affected tooth surfaces. Conclusions Graded clustering patterns of caries and socioeconomic disadvantage are encapsulated within families in Denmark, contributing to the engendering of health inequalities in society. With sibling caries being such a pertinent marker of increased caries risk, caries in a sibling should elicit preventive family-based approaches targeting co-siblings, particularly in socially disadvantaged households. Since caries shares common risk factors with other non-communicable diseases and conditions (such as diabetes and obesity), such policy constructs could reduce not only caries experience but also wider health inequalities in society.

Does the association between teen births or abortions and educational attainment vary by socioeconomic background in Finland?

Teen mothers often have a lower socioeconomic position as adults than other women due to selection, opportunity costs of childbearing, or both. Few studies examine whether that is the case after an induced abortion as well. Also, few studies explore whether the strength of the association between teen pregnancy and adulthood socioeconomic position differs by family background. This study uses Finnish register data of 53,252 women born between 1975 and 1979 to examine with logistic regression whether the likelihood of having tertiary education depends differently on teen birth and abortion experiences by parental socioeconomic position. I also control for and report whether having a partner providing childcare helps mitigate the negative association between teen motherhood and education. The results show teen mothers had lower odds than those who aborted to have tertiary education, and both groups were behind those with no teen pregnancy. These groups’ education did not vary statistically significantly by family background, although the gap in the probability of having tertiary education between teen mothers and those with no teen pregnancy among the lowest socioeconomic backgrounds was 43%-points, and only 27%-points among the highest. Teen mothers with and without a partner had similar probabilities of having tertiary education (8– 11%). Those who had an abortion and subsequently separated from their partner, however, had similar probability of having tertiary education as teen mothers (13%), although others who had an abortion had a much higher probability (20%). Selection shapes these relationships. Survey and register data should be combined to study these associations using methods of causal inference.

Birth weight, gestational age and late adolescent liver function using twin status as instrumental variable in a Hong Kong Chinese birth cohort: “Children of 1997”

Birth weight (BW) is inversely associated with diabetes and liver function in Mendelian Randomization studies. Observationally, lower BW is usually also associated with poorer liver function. However, these studies could be confounded by socioeconomic position. Here we assessed if BW is associated with liver function in a unique population with little socio-economic patterning of BW, using both instrumental variable and an observational analysis.We used instrumental variable analysis (IVA) to assess the association of BW with liver function (alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, and albumin) at ~17 years with twin status as an instrumental variable in the prospective population-representative “Children of 1997” birth cohort (n = 8327). We also conducted an observational analysis adjusted for sex, maternal age, maternal migrant status, smoking and parental socio-economic position. A generalized linear model with gamma family was used for ALT, ALP, and bilirubin because they are not normally distributed.Using IVA, BW was not associated with ALT, ALP or bilirubin, but was possibly negatively associated with albumin (−1.12 g/L, 95% confidence interval (CI) −2.08 to −0.16). Observationally, BW was negatively associated with ALT (−1.23 IU/L, 95% CI −2.16 to −0.30), ALP (−1.72 IU/L, 95% CI −3.43 to −0.01) and higher albumin (−0.23 g/L, 95% CI −0.40 to −0.06).Poor liver function may be a pathway by which the risks of lower BW are actuated. This insight might help identify post-natal targets of intervention to mitigate the adverse health effects of lower birth weight.

Parental and/or Personal Socioeconomic Circumstances: How to Explain Site-Specific Cancer Mortality Inequalities Among Young Belgian Adults

Both socioeconomic position (SEP) in childhood and adulthood are associated with adult mortality. Yet, the relative importance of childhood socioeconomic (SE) conditions is likely to vary depending on the cause of death. This paper will study: 1) whether SE conditions during both childhood and adulthood are associated with overall and site-specific cancer mortality among Belgian young adults; 2) the relative importance of all indicators of parental and personal SEP in explaining differences in cancer mortality. Data were derived from record linkage between the Belgian censuses of 1991 and 2001 and mortality follow-up data for 2001-2011. Parental educational attainment, parental occupational status, parental housing status, and childhood area deprivation were used as measures of parental SEP, and current education as indicator of personal SEP. SE differences were studied for overall and site-specific cancer mortality by calculating age-standardized mortality rates and mortality rate ratios using Poisson regression. Both low parental and personal SEP are associated with higher all-cancer mortality in young adulthood. Personal education seemed to be the strongest indicator of overall and site-specific cancer mortality in young adulthood, independent of parental SEP. Yet, for women, this was partly due to a health selection effect. In the full models, parental SEP was no longer associated with cancer mortality but deprived living conditions still were. Site-specific inequalities were generally more expressed among women than among men. Studies and policies focussing on SE inequalities in mortality in young adulthood should allow for both childhood and adulthood SE conditions.

Comparing Observed and Unobserved Components of Childhood: Evidence From Finnish Register Data on Midlife Mortality From Siblings and Their Parents.

In this study, we argue that the long arm of childhood that determines adult mortality should be thought of as comprising an observed part and its unobserved counterpart, reflecting the observed socioeconomic position of individuals and their parents and unobserved factors shared within a family. Our estimates of the observed and unobserved parts of the long arm of childhood are based on family-level variance in a survival analytic regression model, using siblings nested within families as the units of analysis. The study uses a sample of Finnish siblings born between 1936 and 1950 obtained from Finnish census data. Individuals are followed from ages 35 to 72. To explain familial influence on mortality, we use demographic background factors, the socioeconomic position of the parents, and the individuals' own socioeconomic position at age 35 as predictors of all-cause and cause-specific mortality. The observed part-demographic and socioeconomic factors, including region; number of siblings; native language; parents' education and occupation; and individuals' income, occupation, tenancy status, and education-accounts for between 10 % and 25 % of the total familial influence on mortality. The larger part of the influence of the family on mortality is not explained by observed individual and parental socioeconomic position or demographic background and thus remains an unobserved component of the arm of childhood. This component highlights the need to investigate the influence of childhood circumstances on adult mortality in a comprehensive framework, including demographic, social, behavioral, and genetic information from the family of origin.

Socioeconomic position and self-harm among adolescents: a population-based cohort study in Stockholm, Sweden

BackgroundUnderstanding the association between parental socioeconomic position and self-harm in adolescence is crucial due to its substantial magnitude and associated inequality. Most previous studies have been either of cross-sectional nature or based solely on self-reports or hospital treated self-harm. The aim of this study is to determine the association between parental socioeconomic position and self-harm among adolescents with a specific focus on gender and severity of self-harm.MethodsA total of 165,932 adolescents born 1988–1994 who lived in Stockholm at the age of 13 were followed in registers until they turned 18. Self-harm was defined as first time self-harm and severity of self-harm was defined as hospitalized or not. Socioeconomic position was defined by parental education and household income. Cox proportional hazards regression were used to estimate hazard ratios (HR) with 95% confidence intervals (CI).ResultsAnalyses showed an association between parental socioeconomic position and self-harm. Among adolescents with parents with primary and secondary education compared to tertiary parental education the HR were 1.10 (95% CI 0.97–1.24) and 1.16 (95% CI 1.08–1.25) respectively. Compared to the highest income category, adolescents from the lower income categories were 1.08 (95% CI 0.97–1.22) to 1.19 (95% CI 1.07–1.33) times more likely to self-harm. In gender-stratified analyses, an association was found only among girls. Further, restriction to severe cases eliminated the association.ConclusionsThis study suggested that low parental socioeconomic position is associated with self-harm in adolescence, predominantly among girls. The desertion of an association among severe cases may be explained by differences in suicidal intent and underlying psychiatric diagnosis. Efforts to prevent self-harm should consider children with low parental socioeconomic position as a potential target group.

Adolescent alcohol use and parental and adolescent socioeconomic position in six European cities

BackgroundMany risk behaviours in adolescence are socially patterned. However, it is unclear to what extent socioeconomic position (SEP) influences adolescent drinking in various parts of Europe. We examined how alcohol consumption is associated with parental SEP and adolescents’ own SEP among students aged 14–17 years.MethodsCross-sectional data were collected in the 2013 SILNE study. Participants were 8705 students aged 14–17 years from 6 European cities. The dependent variable was weekly binge drinking. Main independent variables were parental SEP (parental education level and family affluence) and adolescents’ own SEP (student weekly income and academic achievement). Multilevel Poisson regression models with robust variance and random intercept were fitted to estimate the association between adolescent drinking and SEP.ResultsPrevalence of weekly binge drinking was 4.2% (95%CI = 3.8–4.6). Weekly binge drinking was not associated with parental education or family affluence. However, weekly binge drinking was less prevalent in adolescents with high academic achievement than those with low achievement (PR = 0.34; 95%CI = 0.14–0.87), and more prevalent in adolescents with >€50 weekly income compared to those with ≤€5/week (PR = 3.14; 95%CI = 2.23–4.42). These associations were found to vary according to country, but not according to gender or age group.ConclusionsAcross the six European cities, adolescent drinking was associated with adolescents’ own SEP, but not with parental SEP. Socio-economic inequalities in adolescent drinking seem to stem from adolescents’ own situation rather than that of their family.

An analysis of the mental health trajectories of university students compared to their community peers using a national longitudinal survey

ABSTRACTThis study examines the mental health trajectories of future/current undergraduate university students relative to their age-matched community peers from the ages of 15 to 21. It analysed data from the Household, Income and Labour Dynamics in Australia survey. The sample comprised 442 students and 1292 peers. Mental health was assessed with the five-item Mental Health Inventory from the Short Form 36. The results showed that students generally had better mental health than their peers. This was largely associated with better parental mental health and socio-economic position. However, the models also revealed reductions in the mental health of students relative to their peers at ages prior to major transitions in their student careers. This study contributes to the literature on university student mental health by comparing the mental health trajectories of students with their community peers and by identifying the ages when student mental health programmes may be of most benefit.

The importance of early life family factors in the association between cardiovascular risk factors and early cardiovascular mortality

ObjectiveTo explore the importance of early life factors shared by siblings, such as parental socioeconomic position, parental practices, housing and neighbourhood, for the association between cardiovascular disease (CVD) risk factors...

Pathways of Intergenerational Transmission of Advantages during Adolescence: Social Background, Cognitive Ability, and Educational Attainment

Educational attainment in adolescence is of paramount importance for attaining higher education and for shaping subsequent life chances. Sociological accounts focus on the role of differences in socioeconomic resources in intergenerational reproduction of educational inequalities. These often disregard the intergenerational transmission of cognitive ability and the importance of children's cognitive ability to educational attainment. Psychological perspectives stress the importance of cognitive ability for educational attainment but underemphasize potentially different roles of specific socioeconomic resources in shaping educational outcomes, as well as individual differences in cognitive ability. By integrating two strands of research, a clearer picture of the pathways linking the family of origin, cognitive ability, and early educational outcomes can be reached. Using the population-based TwinLife study in Germany, we investigated multidimensional pathways linking parental socioeconomic position to their children's cognitive ability and academic track attendance in the secondary school. The sample included twins (N = 4008), respectively ages 11 and 17, and siblings (N = 801). We observed strong genetic influences on cognitive ability, whereas shared environmental influences were much more important for academic tracking. In multilevel analyses, separate dimensions of socioeconomic resources influenced child cognitive ability, controlling parental cognitive ability. Controlling adolescent cognitive ability and parental cognitive ability, parental socioeconomic resources also directly affected track attendance. This indicated that it is crucial to investigate the intertwined influences on educational outcomes in adolescence of both cognitive ability and the characteristics of the family of origin.

Causal effects of transitions to adult roles on early adult smoking and drinking: Evidence from three cohorts

Transitions into work and family roles have become increasingly delayed as participation in tertiary education widens. Such transitions may have adverse or beneficial effects on health behaviours such as smoking and drinking (alcohol). Role socialisation effects may reduce smoking or drinking, but clustering of transitions may lead to role overload, weakening or reversing any role socialisation effects. Effects of transitions were examined in three UK cohorts: the 1958 National Child Development Study, the 1970 British Birth Cohort Study, and the West of Scotland: Twenty-07 Youth Cohort (from around Glasgow, growing up in the same time period as the 1970 cohort). Latent class analysis was employed to identify heterogeneous patterns of transition timing for leaving education, entering employment, starting cohabitation, having a first child, and leaving the parental home. Propensity weighting was then used to estimate causal effects of transition patterns (relative to tertiary education) on smoking and heavy drinking in early adulthood (ages 22–26), adjusting for background confounders (gender, parental socioeconomic position, family structure, parental and adolescent health behaviours, adolescent distress and school performance). Three groups made early (age 16) transitions from education to employment and then either delayed other transitions, made other transitions quickly, or staggered transitions with cohabitation beginning around ages 19–21; a fourth group transitioned from education to employment around ages 17–18. Compared to those in tertiary education with similar background characteristics, those in these groups generally had higher levels of smoking, especially where transitions were more clustered, but less heavy drinking (except those who delayed other transitions after moving into employment). Results partially supported role socialisation effects for drinking, and role overload effects for smoking. Wider participation in tertiary education could have helped reduce smoking levels in these cohorts, but might also have increased risk for heavy drinking.

Associations Between Preschool Education Experiences and Adulthood Self-rated Health.

ObjectivesThis study aimed to examine the association between preschool education experiences and adulthood self-rated health using representative data from a national population-based survey.MethodsData from the Korean Labor and Income Panel Study in 2006 and 2012 were used. A total of 2391 men and women 21-41 years of age were analyzed. Log-binomial regression analyses were conducted to examine the associations between preschool education experience and self-rated health in adulthood. Parental socioeconomic position (SEP) indicators were considered as confounders of the association between preschool education experience and adulthood subjective health, while current SEP indicators were analyzed as mediators. Age-adjusted prevalence ratios (PRs) and the associated 95% confidence intervals (CIs) were estimated.ResultsCompared with men without any experience of preschool education, those with both kindergarten and other preschool education experiences showed a lower prevalence of self-rated poor health (PR, 0.65; 95% CI, 0.47 to 0.89). In women, however, such an association was not evident. The relationship of preschool education experiences with self-rated poor health in adulthood among men was confounded by parental SEP indicators and was also mediated by current SEP indicators. After adjustment for parental and current SEP indicators, the magnitude of the associations between preschool education experiences and adulthood subjective health was attenuated in men.ConclusionsPreschool education experience was associated with adulthood self-rated health in men. However, this association was explained by parental and current SEP indicators. Further investigations employing a larger sample size and objective health outcomes are warranted in the future.

The role of social position and depressive symptoms in adolescence for life-course trajectories of education and work: a cohort study.

BackgroundWhile a vast amount of studies confirm the social reproduction of class and status from one generation to the next, less is known about the role of health in the child generation for these processes. Research has shown that particularly mental distress in adolescence is important for future life chances. This study aimed to examine the importance of parental socioeconomic position and depressive symptoms in youth for life-course trajectories of education and labour market attachment among men and women.MethodsBased on four waves of questionnaire data from the Northern Swedish Cohort (n = 1,001), consisting of individuals born in 1965, three steps of gender-separate analyses were undertaken. First, the individual trajectories of education and labour market attachment from age 18 to 42 were mapped through sequence analysis. Second, cluster analysis was used to identify typical trajectories. Third, two indicators of parental socioeconomic position – occupational class and employment status – and depressive symptoms at age 16 were used in multinomial regression analyses to predict adult life-course trajectories.ResultsFour typical trajectories were identified for men, of which three were characterised by stable employment and various lengths of education, and the fourth reflected a more unstable situation. Among women, five trajectories emerged, characterised by more instability compared to men. Low parental occupational class and unemployment were significantly associated with a higher risk of ending up in less advantaged trajectories for men while, for women, this was only the case for occupational class. Youth levels of depressive symptoms did not significantly differ across the trajectories.ConclusionsThis study found support for the intergenerational reproduction of social position, particularly when measured in terms of parental occupational class. Youth depressive symptoms did not show clear differences across types of trajectories, subsequently impeding such symptoms to trigger any selection processes. While this could be a consequence of the specific framework of the current study, it may also suggest that depressive symptoms in youth are not a root cause for the more complex processes through which how social position develops across life. The possible impact of welfare and labour market policies is discussed.

Family socioeconomic position in early life and onset of depressive symptoms and depression: a prospective cohort study

PurposeTo investigate whether low parental socioeconomic position (SEP) at birth is associated only with early-onset depressive symptoms in offspring.MethodsThis prospective cohort study used data on 9193 individuals (4768 females, 4425 males) from the Avon Longitudinal Study of Parents and Children. Depressive symptoms during three age periods (10–12, 12–16, 16–20 years) were assessed using the Short Mood and Feelings Questionnaire, and ICD-10 depression at age 18 was assessed using the Clinical Interview Schedule-Revised.ResultsLow SEP was associated with increased incidence rates of depressive symptoms in all age periods, with indicators of low standard of living showing the strongest associations. For instance, incidence rate ratios for material hardship were 1.75 (95% CI [1.42–2.15]) at 10–12 years, 1.36 (1.16–1.61) at 12–16 years and 1.39 (1.21–1.59) at 16–20 years. Low SEP was also associated with increased odds of ICD-10 depression at 18 years, ranging from OR = 1.20 (95% CI [0.94–1.52]) for manual social class to 1.74 (1.35–2.24) for material hardship.ConclusionsThere was no evidence that depressive symptoms can be “subtyped” by the age of onset, because the association with low SEP was evident for early- and later-onset symptoms. If socioeconomic inequalities in early life have long-term adverse impacts on mental health, policies addressing these inequalities could benefit the mental health of the population.

Education as a social pathway from parental socioeconomic position to depression in late adolescence and early adulthood: a Finnish population-based register study

There is inconsistent evidence for social differentials in the risk of depression in youth, and little is known about how education at this age influences the risk. We assess how parental socioeconomic position (SEP) and education predict depression from late adolescence to early adulthood, a time of major educational transitions. We followed a nationally representative 20% sample of Finnish adolescents born in 1986-1990 (n=60,829) over two educational transitory stages at the age of 17-19 and 20-23 covering the years 2003-2011. We identified incident depression using health care register data. We estimated the risk of depression by parental SEP and personal education using Cox regression, adjusting for family structure, parental depression and the individual's own psychiatric history. Lower parental income was associated with up to a twofold risk of depression. This effect was almost fully attributable to other parental characteristics or mediated by the individual's own education. Educational differences in risk were attenuated following adjustment for prior psychiatric history. Adjusted for all covariates, not being in education increased the risk up to 2.5-fold compared to being enrolled in general upper secondary school at the age of 17-19 and in tertiary education at the age of 20-23. Vocationally oriented women experienced a 20% higher risk than their academically oriented counterparts in both age groups. Education constitutes a social pathway from parental SEP to the risk of depression in youth, whereby educational differences previously shown in adults are observed already before the establishment of adulthood SEP.

Mental health associations with eczema, asthma and hay fever in children: a cross-sectional survey

ObjectiveThis study aimed to examine the association of eczema, asthma and hay fever with mental health in a general child population and to assess the influence of parental socioeconomic position...

The Effects of Life Events and Socioeconomic Position in Childhood and Adulthood on Successful Aging.

Building on social stress theory, this study has 2 aims. First, we aim to estimate the effects of stressful life events in childhood and adulthood on Successful Aging (SA). Second, we examine how unequal exposure to such life events between individuals with different socioeconomic position (SEP) contributes to socioeconomic inequalities in SA. We used 16-year longitudinal data from 2,185 respondents aged 55-85 years in 1992 in the Dutch nationally representative Longitudinal Aging Study Amsterdam. Measurement of SA was based on earlier work, in which we integrated trajectories in 9 indicators of functioning into an index of SA. Using path analysis, we investigated direct and indirect effects of parental and adulthood SEP as well as of self-reported childhood and adulthood life events on SA. Almost all included life events had negative direct effects on SA. Parental SEP had no direct effect on SA, whereas adulthood SEP had. Higher Parental SEP increased the likelihood of parental problems and parental death in childhood, resulting in negative indirect effects on SA. Higher adulthood SEP had both positive and negative indirect effects on SA, through increasing the likelihood of divorce and unemployment, but decreasing the likelihood of occupational disability. SEP and particular stressful life events are largely, but not entirely independent predictors of SA. We found that high and low SEP may increase exposure to particular events that negatively affect SA. Findings suggest that low (childhood) SEP and stressful life events are interrelated factors that may limit individual opportunities to age successfully.

Accounting for Life-Course Exposures in Epigenetic Biomarker Association Studies: Early Life Socioeconomic Position, Candidate Gene DNA Methylation, and Adult Cardiometabolic Risk.

Recent studies suggest that epigenetic programming may mediate the relationship between early life environment, including parental socioeconomic position, and adult cardiometabolic health. However, interpreting associations between early environment and adult DNA methylation may be difficult because of time-dependent confounding by life-course exposures. Among 613 adult women (mean age = 32 years) of the Jerusalem Perinatal Study Family Follow-up (2007-2009), we investigated associations between early life socioeconomic position (paternal occupation and parental education) and mean adult DNA methylation at 5 frequently studied cardiometabolic and stress-response genes (ABCA1, INS-IGF2, LEP, HSD11B2, and NR3C1). We used multivariable linear regression and marginal structural models to estimate associations under 2 causal structures for life-course exposures and timing of methylation measurement. We also examined whether methylation was associated with adult cardiometabolic phenotype. Higher maternal education was consistently associated with higher HSD11B2 methylation (e.g., 0.5%-point higher in 9-12 years vs. ≤8 years, 95% confidence interval: 0.1, 0.8). Higher HSD11B2 methylation was also associated with lower adult weight and total and low-density lipoprotein cholesterol. We found that associations with early life socioeconomic position measures were insensitive to different causal assumption; however, exploratory analysis did not find evidence for a mediating role of methylation in socioeconomic position-cardiometabolic risk associations.