Pathways to health: direct and indirect effects of early life conditions on later health

Early life conditions have profound long-term health consequences over the life course. However, previous studies concentrate almost exclusively on the detrimental impact of fetal and early childhood malnutrition on adult health; by contrast, little attention has been paid to late childhood nutrition, which is also highly relevant in one’s growth trajectory and health outcome. This is the case especially in developing countries. We use data recently collected from a nationally representative sample survey of the Chinese population to explore the impact of late childhood nutrition intakes on adult health. The underlying linkage between childhood nutrition, adult height and a broad range of subjective and objective health indicators will be examined.

Population ageing is one of the dominant trends of the 21st century. Considering that morbidity is concentrated in the older population interventions to promote healthy ageing and healthy life expectancy are needed in order to offset the effects that ageing will have on population health. Health related behaviour use is a focal area for possible interventions since its association with various health outcomes is well documented. We used data from the English Longitudinal Study of Ageing with a formal approach for the identification of mediating factors in order to investigate the lifecourse socio-economic patterning of smoking, physical activity, dietary habits and alcohol use in later life. We observed socio-economic gradients in smoking, physical activity and alcohol use, but to a lesser extend in healthy dietary habits. Both early and later life socio-economic circumstances influenced health related behaviour, but these associations differed between men and women as well as between age groups. We found that early life circumstances influence behaviour either directly or indirectly 65 years after and their effect reaches until early old age. The complexity of the observed associations highlights the need for further research on the mechanism that underlies the links between SEP and later life health related behaviour.

In the past 50 years, Latin America observed a significant improvement in the living conditions of its population, reflected in better health and economic indicators. However, inequality in living conditions in these countries has been largely unexplored by the absence of economic data sets and health. This paper uses the adult height as a health indicator of living conditions during childhood and adolescence in Latin America. We use data from from demographic and health surveys (DHS) for eleven countries in the region conducted after 2000. The results suggest that although it has been a positive trend in nutritional status and living conditions over time, nutritional inequality seems to have remained constant over time, which has significative impacts on adult health, measure by adult heights.
Keywords: adult height, living conditions, nutritional inequality.

Maternal mortality and morbidity issues in Nigeria have continued to generate series of concerns in health literature. This is given that the conditions of pregnant women are characterised by poor dietary habits consistent with low food intake before, during and after pregnancy resulting in high rate of maternal deaths. This study therefore investigated the socio-cultural correlates of food intake among pregnant women in Southwest Nigeria as a way of understanding the context in which pregnancy outcomes take place. Data were collected through Focus Group Discussions (FGDs), Observation, In-depth Interviews (IDIs) and survey questionnaire. The findings show that patterns of social relationships existing between family members like Mother-in-laws, parents, siblings, cognates, members of religious group and neighbours have significant influence on women’s food intake during pregnancy and lactation; men’s choice of food affects women’s food preference and eating patterns during the period of pregnancy.
The objectives of the study include examining the relationship between factors related to cultural, demographic, and socioeconomic status of women and food intake during pregnancy.

Unlike previous migration studies which mainly focus on individual migration, this article examines the long-term mortality consequences of childhood migration and resettlement. Using a unique Chinese historical population database, we trace 30517 males from childhood onwards between 1792 and 1909, 542 of whom experienced childhood migration. We apply discrete-time event-history analysis and include a fixed effect of common grandfather to account for unobservable characteristics of the extended family. We also explore the influence of social networks on early-life migration experience by including kin network at destination. Our findings suggest that migration in childhood has substantial long-term effects on survivorship in later ages. From age 16 to 45, kin network at destination mediates the negative effects of childhood migration and lowers mortality risks. Moreover, child migrants who survive to older ages subsequently experience lower mortality. Such findings contribute to a better understanding of the implications of social behavior and social context for human health.

This paper examines the impact of antenatal care (ANC) on neonatal mortality using nationally representative data from India. For the first time, we apply the WHO Framework of effective coverage to measure health systems performance of ANC. We define effective coverage by creating an “Ideal” package of ANC consisting of 10 key interventions, and also define “Less Than Ideal” packages comprising different combinations of less than the 10 interventions. Using data from over 60,000 mother-child dyads from 1998/9 and 2005/6 National Family Health Surveys of India, we use multivariable logistic regression models to examine the association of ANC on neonatal mortality.

We find that only 10.4% of Indian women received effective ANC. There is substantial socioeconomic variation, with a 10-fold difference in effective coverage between the richest and poorest wealth quintile. Effective coverage is significantly associated with a 51% reduction in the odds of neonatal mortality (OR: 0.49; 95% CI: 0.36-0.67). This “Ideal package is more protective against neonatal mortality than other “Less Than Ideal” packages.

India’s health system is not meeting the needs of pregnant women. Improving utilisation and delivery of the components of ANC to improve service quality, has important consequences for improving child health in India.

Women constitute half the population and their health is infrastructure of families' and communities' health. Their problems will be effective on physical and mental health of family, community and even future generations. Women's health includes physical, mental, social, cultural, emotional and spiritual welfare and is influenced by physiological, social, economic and political factors. One of the most important social factors affecting women's health is social support. This article is intended to examine social factors affecting women's health with an emphasis on social support.
Materials and Methods: This research is an applied review which is extensive and has a micro level of range and also is Cross-sectional study. Research method is field method and survey technique is used and a tool for data collection is questionnaire. Statistical Society in this study is all women above 18 years in Kermanshah city that 345 of them were studied by using multi-stage sampling as the sample.
The findings suggest that there is a significant relationship between social support and women health. Also among other social variables such as education, parent education, employment status, economic class and religion, there is a significant relationship with women's health.
Key words: Women's Health, Social Factors, Social Protection.

Pregnancy symptoms and complications can range from mild and annoying discomforts to severe, sometimes life-threatening illnesses. Problems during pregnancy may include physical and psychological conditions that negatively affect the health of the mother or the baby (Bruce et al. 2008). In this paper an attempt has been done to see the association of maternal obesity with pregnancy related complications viz. namely menstruation cycle disturbance, mode of delivery and adverse pregnancy outcome (miscarriage and stillbirth) among the women in reproductive ages with the National Family Health Survey-3 data. Results show that maternal obesity is frequently associated with menstruation cycle disturbance. Increasing maternal BMI results into increased risk of delivery by emergency caesarean section. Results also suggest that overweight and obesity may increase the risk of adverse pregnancy outcomes among younger women, whereas this relationship is not observed among older women.

This paper examines the intergenerational effects of maternal micronutrient supplementation with iron and folic acid on the outcome of low birthweight in India.

Using data from the nationally-representative 1998/9 and 2005/6 National Family Health Surveys of India, we assess the population-level effectiveness of iron and folic acid supplementation on low birthweight and birthweight, using multivariable logistic and linear regression models respectively.

We find that only two-thirds of women report taking iron and folic acid supplementation during pregnancy, of whom only one-quarter for the recommended duration. Maternal supplementation is significantly negatively associated with low birthweight, after adjustment for socioeconomic status (OR: 0.77; 95% CI 0.68-0.87), and further adjustment for antenatal care utilization (ANC) (OR: 0.82; 95% CI 0.72-0.94). This corresponded to a 41.28g (95% CI 2.32g-80.2g) increase in birthweight, which attenuated to 27.59g (95% CI -12.4g-67.6g) after adjustment for ANC.

These findings have important implications as India accounts for about 40% of the global burden of low birthweight. Improved implementation of this simple intervention may help reduce intergenerational transmission of poor health status, and reduce India’s burden of low birthweight, and its sequelae.

This paper examines the effects of exposure to the Spanish flu during infancy and in-utero, identified as critical periods in the physiological development of the individual, on socio-economic position and health in later life. The data used is from the Scanian Economic-Demographic Database, which includes individual level longitudinal data, both demographic and economic, for five rural parishes in southern Sweden, from the nineteenth century until today. In this paper we focus on the birth cohorts born between 1912 and 1925. We have previously shown that those born immediately before the Spanish flu and exposed in the first year of life are less able to reach higher socio-economic positions than cohort born before or afterwards (Bengtsson and Helgertz 2012). In this paper we expand this analysis by following these cohorts until later in life to examine lasting health impacts of the Spanish flu. Doing so we take both direct and indirect effects—via income and socio-economic position—into account by making use of a structural equation modeling approach. The overall finding is that exposure to the Spanish flu in first year of life affects both economic outcomes and health in older ages, and that health is affected directly, not via income and socio-economic position.