Heterogeneity in chronic disease outcomes among women and men in midlife: Examining the role of stability and change in childhood economic hardship

Abstract

In this study, we advance existing research on the long-term effects of childhood disadvantage on health in adulthood by examining how the timing and duration of childhood economic hardship differentiates between those at low and high risk of chronic disease onset in midlife for women and men, across four different health outcomes. The study uses prospective data on childhood and adulthood from the US Panel Study of Income Dynamics and discrete time hazard models are estimated using logistic regression. Results indicate that, in general, childhood economic context results in an increased risk of multiple diseases for women but not for men. Specifically, women who experienced long-term economic hardship in childhood, or began life in poverty but moved out of poverty in childhood, were more likely to experience the onset of diabetes, arthritis, and cardiovascular diseases in midlife, net of other factors, such as adult resources. The impact of childhood economic hardship on disease onset also varied by age for women but not for men, and this relationship was also dependent on the health outcome examined. This study draws attention to the importance of conceptualising and measuring childhood disadvantage as dynamic, and reveals that the process of cumulative disadvantage may be different for women and men.