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

We combined a life course perspective with a multilevel approach to analyze the impact of financial resources (both income and wealth) on self rated health over time in different countries and social systems. Therefore, we used the baseline interviews of the first two ways of the Survey of Health, Ageing and Retirement in Europe and the third wave of the English Longitudinal Study of Ageing (ELSA), and combined these data with the recently published retrospective interviews from SHARELIFE and the life histories from ELSA to take childhood conditions (socio-economic background, health) and conditions in adulthood (number of illnesses, unemployment spells) into account. Country level differences were measured in terms of income inequality (gini coefficient) in a society. To disentangle how childhood and adulthood factors as well as contextual influences affect old age health,, structural equation models were used. Results show that income inequality has a small positive indirect effect on individual health, while the direct effect is negative, indicating that health status is negatively affected by the unequal distribution of resources in a society.

Quantifying women social and health status through data collection from household surveys is a key step to measure and monitor the achievements of development objective and MDGs. There are a number of robust survey tools to measure women status in the reproductive age, and few attempts to collect information about adolescence, menopause and elderly stages of women life in an integrated life course context. There is also evidence that a life course approach would provide an outstanding opportunity to understand the interaction across life stages and the impact of knowledge, perception and behavior in one stage on the consequent stages. While the literature introduced a theoretical framework on the lifecycle approach it lacked operational framework to serve an effective woman-centered development programs. This paper sheds lights on the insights of life course approach, and utilizes the lessons learned from Iraq Integrated Women Health and Social Status (I-WISH). It provides empirical evidence on the importance and value added for introducing a lifecycle survey tool, and points out the technical difficulties to develop such a tool. It calls for more effort to develop such a tool kit for the sake of further development in the field of the social research on women lifecycle health and social status.

We analysed the extent to which associations between parenthood histories and later life health are mediated by wealth, health-related behaviours, social support and strain. A sample of men and women aged 50+ who participated in the English Longitudinal Study of Ageing waves 1-3 was used (n = 6,207). Parenthood history included number of natural children, having adopted or step children and timing of first and last birth. Mediators were wealth, social support and strain, smoking and physical activity. Health outcomes were allostatic load and limiting long-term illness. The path models were adjusted for age, education, marital history, childhood health and intergenerational contacts. The association between a higher number of children and health was mediated by wealth in men and women, and by smoking and social strain in women. The association between having an adopted or step child and health was mediated through wealth. In addition to mediation through wealth, physical activity and smoking, mothers had a direct association between early childbirth and allostatic load. Among fathers, the direct paths from early and late childbirth to health remained, although some of the effects were mediated through wealth and physical activity.

Rates of morbidity and mortality in the UK are higher for non-white ethnic minority groups compared with the white majority population. Ethnic health inequalities have been partly attributed to lower socioeconomic resources and experienced racism. However, there is still substantial debate on the causal mechanisms behind health inequalities, and it is not clear when and how the ethnic patterning of chronic disease risk emerges during the early life course, and how this varies across ethnic groups.
There are important differences in the processes that have led to the ethnic makeup of the populations in the UK, including motivations for and patterns of migration, and both historical and contemporary ethnic relations. Hypothesised causal factors of ethnic health inequalities may thus differ substantially across ethnic groups, leading to possible variations in the patterning of ethnic health inequalities.
This study will analyse a birth cohort with an oversample of ethnic minority children in the UK to examine and compare inequalities in child health and development across ethnic groups, exploring cognitive development and socioemotional behaviours. Results will make a unique contribution to research on ethnic inequalities in child development and health, allowing a better understanding of the determinants of health inequalities

Using data from the Birth to Twenty (Bt20) 1990 Johannesburg-Soweto born cohort, this paper aims to advance the understanding of links between the experiences of early life-course socio-demographic transitions and their association with body mass index (BMI) in a rapidly transitioning urban environment. A variety of regression modelling techniques are used to examine associations between early life-course socio-economic status (SES) transitions between birth and late adolescence and demographic change (move of address, or primary caregiver marital status change) with changes in BMI and/or obesity risk. Initial results show that for females, a strong positive association between residential mobility and BMI is observed for those also experiencing increased household SES between birth and 12/13 years, while no effect is observed for males. This was shown against a context of a tripling of the female overweight prevalence between late childhood and age 15 years. Further analyses will explore at what age between birth and late adolescence changes in the socio-demographic environment associate most with BMI change. Current findings suggest that targeting those on an upwardly mobile SES trajectory within changing urban environments undergoing nutrition transition with interventions to prevent obesity could have positive benefits.

The paper uses CLHLS data from 1998 to 2005, employing Cox hazard regression model to analyze the impact of religious attendance on the mortality risk of the oldest old, and to examines the roles of physical/mental health, healthy behaviors and socioeconomic supports in this relationship, in order to test four kinds of theoretical models in the western literature. The results show that religious attendance is correlated with mortality risk. However, the effects of other potential explanatory variables can somehow reduce the association. These findings suggest that religious attendance may represent a proxy for physical health, especially in the oldest old.

This paper examines the determinants of chronic health conditions and explains their persistence, using a panel data set from the Indonesian Family Life Survey (IFLS). I incorporate dynamics into a health demand function, finding strong correlations between lagged and current health measures when nothing else is controlled. This could represent the influence of lagged health or fixed unobserved factors such as genetic endowments and childhood health. To disentangle these, I estimate the influence of lagged health by using first-difference two-step generalized method of moments (FD-GMM), where the first-differencing removes fixed unobserved factors and keeps only lagged health. I found that it is this fixed effect, representing both genetic endowments and childhood health, that is most important in explaining later life chronic conditions. The impact of past health conditioning on the fixed effect, captured by the coefficients on lagged health measures, is weak, with estimated coefficients relatively close to zero. These results are robust to potential measurement errors in health and to sample attrition. Socio-economic status also has very little influence on current health, again conditioned on the fixed effect and on the influence of lagged health.

Cognitive impairment and dementia are major health problems confronting older persons. Blacks are especially hard hit by cognitive impairment and dementia in the U.S. It is estimated that among those aged 71 years and older Blacks were approximately two times more likely to have dementia than Whites. Despite developments in understanding the risk factors associated with cognitive impairment and dementia in recent years, very few population-level studies have investigated the origins and mechanisms through which the racial gap in cognitive impairment is produced. In this study, using data from 7 waves of the Health and Retirement Study (1998-2010), we analyzed how racial differences in cognitive impairment are tied to the racial stratification of childhood resources and health, adult socioeconomic status, health, and health behaviors among 9044 non-Hispanic Whites and Blacks aged 65 and older in 1998. Our preliminary results showed that older Blacks were about three times more likely to suffer from cognitive impairment than Whites in 1998, and childhood conditions including childhood health, parental education, and father's occupation as well as adult socioeconomic achievement played an important role in accounting for racial disparities in cognitive impairment in later life.

The study assesses the effects of household structure on children’s nutritional status in Ethiopia using data obtained from 8847 children sampled in the 2004 National Welfare Monitoring Survey. Hypotheses dealing with the linkage between child well-being and household structure are tested. The results revealed that children in single parent nuclear households are much more vulnerable to poor nutritional status than those in two-parent nuclear and extended households. The persistent disadvantageous position of poor and single parent households that do not have access to high child caring capacity and welfare support unveils that lack of resources (i.e. financial, material, and labor) within the household affects
child well-being in traditional societies like Ethiopia. High level of maternal education is associated with a better nutritional status of children while large number of siblings increases the likelihood of being stunted. Thus, household structure affects the nutritional status of children through the mediating effects of economic and socio-cultural factors.

There is growing evidence that maternal psychological stress during pregnancy, negatively affects a wide variety of offspring outcomes. Animal studies suggest that negative influences of maternal stress during pregnancy persist across multiple generations, but there is little direct evidence confirming that it is present among human populations. This study draws evidence on the intergenerational influences of maternal stress from the Kwangju uprising (May 18-27), arguably the bloodiest incidence that has occurred in South Korea since the end of the Korean War in 1953. The micro files of the 2000 and 2002 Vital Statistics of South Korea are utilized for the study. The results of difference-in-difference estimations suggest that in-utero exposure to the Kwangju uprising significantly diminished the offspring birth weight and length of gestation. The impact of exposure to maternal stress differs by stage of pregnancy when the shock is received. Exposure to stress during the second trimester of pregnancy exerted the strongest negative effect on grandchildren’s birth weights. As for the length of gestation, the second and third trimesters were equally critical.