Social and economic conditions in childhood and the progression of functional health problems from midlife into old age.
BACKGROUND
Childhood living conditions have been found to predict health and mortality in midlife and in old age. This study examines the associations between social and economic childhood conditions and the onset and progression of functional health problems from midlife into old age, and the extent to which potential associations are mediated by educational attainment and smoking.


METHODS
Data from the Level of Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old were merged to create a longitudinal data set with five repeated measures from 1968 to 2004 (n=1765, aged 30-50 years and free from functional health problems at baseline). Multilevel regression models were used to analyse retrospective reports of social and economic conditions in childhood (eg, conflicts or economic problems in the family) in relation to the progression of functional health problems over the 36-year period.


RESULTS
Results showed that social and economic disadvantages in childhood were associated with an earlier onset and a faster progression of functional health problems from midlife into old age. Subsequent models showed that differences in educational attainment, but not smoking, explained much of the association between childhood disadvantages and trajectories of functional health problems.


CONCLUSIONS
According to these results, adverse social and economic conditions in childhood affect the development of functional health problems from midlife into old age indirectly through less favourable life careers, including lower education. Creating equal opportunities for educational attainment may help reduce the long-term effects of disadvantaged childhood conditions and postpone functional health problems.
Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
Neda
N
Agahi
School of Public Health, University of Albany, State University of New York, New York, USA.
Benjamin A
BA
Shaw
Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
Stefan
S
Fors
D000328:Adult; D000375:Aging; D002657:Child Development; D002675:Child, Preschool; D004522:Educational Status; D005195:Family Relations; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011203:Poverty; D036301:Qualitative Research; D012044:Regression Analysis; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D013548:Sweden / Q000453:epidemiology
Ageing; Functioning and disability; Lifecourse / Childhood Circumstances; Longitudinal Studies; Multilevel Modelling