A Changing Landscape of Health Opportunity in the United States: Increases in the Strength of Association Between Childhood Socioeconomic Disadvantage and Adult Health Between the 1990s and the 2010s

Am J Epidemiol. 2021 Mar 12:kwab060. doi: 10.1093/aje/kwab060. Online ahead of print.


Understanding the changing health consequences of childhood socioeconomic disadvantage (SED) is highly relevant to policy debates on inequality and national and state goals to improve population health. However, changes in the strength of association between childhood SED and adult health over historic time are largely unexamined in the United States. The current study begins to address this knowledge gap. Data were from two national samples of adults collected in 1995 (n = 7,108) and 2012 (n = 3,577) as part of the Midlife in the United States study. Three measures of childhood SED (parent occupational prestige, childhood poverty exposure, and parent education) were combined into an aggregate index and examined separately. The association between childhood SED (aggregate index) and five health outcomes (BMI, waist circumference, chronic conditions, functional limitations, and self-rated health) was stronger in the 2012 sample than the 1995 sample, with the magnitude of associations being approximately twice as large in the more recent sample. Results persisted after adjusting for age, sex, race, marital status, and number of children, and were similar across all three measures of childhood SED. The findings suggest that the socioeconomic circumstances of childhood may have become a stronger predictor of adult health in recent decades.

PMID:33710274 | DOI:10.1093/aje/kwab060