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American Journal of Epidemiology Advance Access originally published online on August 23, 2007
American Journal of Epidemiology 2007 166(9):1059-1067; doi:10.1093/aje/kwm185
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2007.

ORIGINAL CONTRIBUTIONS

Childhood Social and Economic Well-Being and Health in Older Age

Sandra Moody-Ayers1,2, Karla Lindquist2, Saunak Sen1,3 and Kenneth E. Covinsky1,2

1 San Francisco VA Medical Center, San Francisco, CA
2 Division of Geriatrics, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA
3 Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA

Correspondence to Dr. Sandra Moody-Ayers or Dr. Kenneth Covinsky, San Francisco VA Medical Center (181G), 4150 Clement Street, San Francisco, CA 94121 (e-mail: sandra.moody{at}va.gov or Ken.Covinsky{at}ucsf.edu).

Received for publication April 14, 2006. Accepted for publication May 17, 2007.

Childhood socioeconomic status (SES) acts over a lifetime to influence adult health outcomes. Whether the impact of childhood SES differs by age or race/ethnicity is unclear. The authors studied 20,566 community-living US adults aged ≥50 years. Parental education was the main predictor. Outcomes evaluated (1998–2002) included self-reported health and functional limitation. The influence of childhood SES on later-life health was also examined in groups stratified by age and race/ethnicity, with adjustment for demographic factors and current SES. Participants' mean age was 67 years; 57% were women. By race/ethnicity, 76% were White, 14% were Black, and 8% were Latino. The relation between low parental education and fair/poor self-rated health declined with advancing age (age 50–64 years: adjusted odds ratio (AOR) = 1.42, 95% confidence interval (CI): 1.24, 1.63; age ≥80 years: AOR = 1.14, 95% CI: 0.96, 1.36). The relation between low parental education and fair/poor self-rated health differed across racial/ethnic groups and was significant in White (AOR = 1.33, 95% CI: 1.21, 1.47) and Black (AOR = 1.37, 95% CI: 1.14, 1.64) participants but not Latinos. These findings suggest that childhood SES affects health status through midlife but the effects may abate in late life; its effects also may be weaker in Latinos than in Whites or Blacks.

activities of daily living; frail elderly; health status; mobility limitation; social class

Abbreviations: ADL, activities of daily living; CI, confidence interval; OR, odds ratio; SES, socioeconomic status


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