Cumulative Childhood Adversity, Educational Attainment, and Active Life Expectancy Among U.S. Adults

Abstract

Studies of the early-life origins of adult physical functioning and mortality have found that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies have generally assessed functioning and mortality as distinct processes and used cross-sectional prevalence estimates that neglect the interplay of disability incidence, recovery, and mortality. Here, we examine whether early-life disadvantages both shorten lives and increase the number and fraction of years lived with functional impairment. We also examine the degree to which educational attainment mediates and moderates the health consequences of early-life disadvantages. Using the 1998–2008 Health and Retirement Study, we examine these questions for non-Hispanic whites and blacks aged 50–100 years using multistate life tables. Within levels of educational attainment, adults from disadvantaged childhoods lived fewer total and active years, and spent a greater portion of life impaired compared with adults from advantaged childhoods. Higher levels of education did not ameliorate the health consequences of disadvantaged childhoods. However, because education had a larger impact on health than did childhood socioeconomic context, adults from disadvantaged childhoods who achieved high education levels often had total and active life expectancies that were similar to or better than those of adults from advantaged childhoods who achieved low education levels.

Genetic variants linked to education predict longevity

“…Individual differences in educational attainment have been linked to variation in life chances and longevity: those with more education tend to be healthier (3), richer in adulthood (4), more upwardly socially mobile (2), and longer-lived (5,6). Because education influences-and is influenced by-various personal characteristics and social factors (7,8), it has been difficult to disentangle the precise reasons for its prediction of key life outcomes (9).…”

What can the life course approach contribute to an understanding of longevity risk?

“…Only recently have researchers begun to take a more integrative view of adult health and examined how life course experiences influence multiple facets of health (e.g., how life course factors influence the interplay of functioning and mortality to determine healthy life expectancy (Montez & Hayward, 2014)). Research rarely explicitly addresses the idea that exposures may give rise to a cascade of adult health conditions starting, say, from morbidity, to disability, and then to mortality -or not.…”

Les disparités d’accès aux soins de santé parmi la minorité de langue officielle au Québec

“…Les dix catégories de revenu ont été regroupées en cinq, pour s'approcher d'une distribution des revenus normale. Les dix catégories de scolarité ont été regroupées en trois, correspondant aux diplômes les plus fortement associés à la position socio-économique (Montez et Hayward, 2014) …”