Social and economic conditions in childhood and the progression of functional health problems from midlife into old age

Abstract

Background: Childhood living conditions have beenfound to predict health and mortality in midlife and inold age. This study examines the associations betweensocial and economic childhood conditions and the onsetand progression of functional health problems frommidlife into old age, and the extent to which potentialassociations are mediated by educational attainment andsmoking.Methods: Data from the Level of Living Survey and theSwedish Panel Study of Living Conditions of the OldestOld were merged to create a longitudinal data set withfive repeated measures from 1968 to 2004 (n=1765,aged 30-50 years and free from functional healthproblems at baseline). Multilevel regression models wereused to analyse retrospective reports of social andeconomic conditions in childhood (eg, conflicts oreconomic problems in the family) in relation to theprogression of functional health problems over the36-year period.Results: Results showed that social and economicdisadvantages in childhood were associated with anearlier onset and a faster progression of functionalhealth problems from midlife into old age. Subsequentmodels showed that differences in educationalattainment, but not smoking, explained much of theassociation between childhood disadvantages andtrajectories of functional health problems.Conclusions: According to these results, adverse socialand economic conditions in childhood affect thedevelopment of functional health problems from midlifeinto old age indirectly through less favourable lifecareers, including lower education. Creating equalopportunities for educational attainment may helpreduce the long-term effects of disadvantaged childhoodconditions and postpone functional health problems.