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Pathways linking combinations of early-life adversities to adult mortality: Tales that vary by gender.

ABSTRACT: RATIONALE:Socioeconomic disadvantage, family instability, and abuse are widely studied early-life adversities (ELAs) that may co-occur in the lives of many. The detrimental effects of these adversities may result in elevated risk of mortality in midlife and old age. OBJECTIVE:We investigate how combinations of these three ELAs affect later-life mortality and the life-course mediators that explain the associations. METHOD:Data come from the first two waves of the Midlife in the United States (MIDUS) study and mortality records over a 20-year period (1995/96-2015). We used latent class analysis (LCA) to identify patterns of ELAs across the three domains and incorporated four life-course mediators: material, psychological, social resources, healthy lifestyle and substance abuse. RESULTS:LCA yielded six distinct combinations of ELAs, with patterns of socioeconomic status (SES) and abuse being most salient. We found that childhood abuse exists across all levels of childhood SES. For both genders, individuals who experienced low SES combined with frequent abuse have the highest risk of death. For women but not men, frequent abuse increases the risk of mortality even if they grew up in middle or high SES families. For both genders, material resource is a significant contributor on the pathway from ELAs to mortality. Life-course mediators partially accounted for the observed associations between ELAs and mortality, but attenuation was stronger for men than women. This is partially attributed to the stronger direct effects of life-course resources on mortality for men than women. CONCLUSIONS:Our findings suggest that ELAs are an important determinant of mortality in midlife and old age. Traumatic experiences during the critical period of early life may compromise later-life heath more for women than men.

SUBMITTER: Lee C

PROVIDER: S-EPMC6894498 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Pathways linking combinations of early-life adversities to adult mortality: Tales that vary by gender.

Lee Chioun C Ryff Carol D CD

Social science & medicine (1982) 20190924

<h4>Rationale</h4>Socioeconomic disadvantage, family instability, and abuse are widely studied early-life adversities (ELAs) that may co-occur in the lives of many. The detrimental effects of these adversities may result in elevated risk of mortality in midlife and old age.<h4>Objective</h4>We investigate how combinations of these three ELAs affect later-life mortality and the life-course mediators that explain the associations.<h4>Method</h4>Data come from the first two waves of the Midlife in ...[more]

PMID: 31585378

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Project description:While research examining the health impact of early socioeconomic conditions suggests that effects may exist independently of or jointly with adult socioeconomic position, studies exploring other potential pathways are few. Following a chain of risk life course model, this prospective study seeks to examine whether pathways of occupational class as well as material and social adversities across the life course link socioeconomic disadvantage in adolescent to functional somatic symptoms in mid-adulthood. Applying path analysis, a multiple mediator model was assessed using prospective data collected during 26 years through the Northern Swedish Cohort. The sample contained 987 individuals residing in the municipality of Luleå, Sweden, who participated in questionnaire surveys at age 16, 21, 30 and 42. Socioeconomic conditions (high/low) in adolescence (age 16) were operationalized using the occupation of the parents, while occupational class in adulthood (manual/non-manual) was measured using the participant's own occupation at age 21 and 30. The adversity measurements were constructed as separate age specific parcels at age 21 and 30. Social adversity included items pertaining to stressful life events that could potentially harm salient relationships, while material adversity was operationalized using items concerning unfavorable financial and material circumstances. Functional somatic symptoms at age 42 was a summary measure of self-reported physical symptoms, palpitation and sleeping difficulties that had occurred during the last 12 months. An association between socioeconomic conditions at age 16 and functional somatic symptoms at age 42 (r = 0.068) which was partially explained by people's own occupational class at age 21 and then material as well as social adversity at age 30 was revealed. Rather than proposing a direct and independent health effect of the socioeconomic conditions of the family, the present study suggests that growing up in an unfavorable socioeconomic environment might be a source for a chain of adverse material and social living situations, which in turn affects adult health.

Project description:BackgroundAlthough investigations have begun to differentiate biological and neurobiological responses to a variety of adversities, studies considering both endocrine and immune function in the same datasets are limited.MethodsAssociations between proximal (family functioning, caregiver depression, and anxiety) and distal (SES-D; socioeconomic disadvantage) early-life adversities with salivary inflammatory biomarkers (IL-1β, IL-6, IL-8, and TNF-α) and hair HPA markers (cortisol, cortisone, and dehydroepiandrosterone) were examined in two samples of young U.S. children (N = 142; N = 145).ResultsChildren exposed to higher SES-D had higher levels of TNF-α (B = 0.13, p = 0.011), IL-1β (B = 0.10, p = 0.033), and DHEA (B = 0.16, p = 0.011). Higher family dysfunction was associated with higher cortisol (B = 0.08, p = 0.033) and cortisone (B = 0.05, p = 0.003). An interaction between SES-D and family dysfunction was observed for cortisol levels (p = 0.020) whereby children exposed to lower/average levels of SES-D exhibited a positive association between family dysfunction and cortisol levels, whereas children exposed to high levels of SES-D did not. These findings were partially replicated in the second sample.ConclusionsOur results indicate that these biological response systems may react differently to different forms of early-life adversity.ImpactDifferent forms of early-life adversity have varied stress signatures, and investigations of early-life adversities with inflammation and HPA markers are lacking. Children with higher socioeconomic disadvantage had higher TNF-α, IL-1β, and DHEA. Higher family dysfunction was associated with higher hair cortisol and cortisone levels, and the association between family dysfunction and cortisol was moderated by socioeconomic disadvantage. Biological response systems (immune and endocrine) were differentially associated with distinct forms of early-life adversities.

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Pathways linking combinations of early-life adversities to adult mortality: Tales that vary by gender.

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Pathways linking combinations of early-life adversities to adult mortality: Tales that vary by gender.

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