Parental socioeconomic position, childhood poverty and healthy aging: retrospective and prospective study of six cohorts across 32 wealthy and developing nations

Abstract

Background and aim Children who were poor in wealthy countries have reported worse cognitive, muscle, and mental functions, as well as greater frailty and multimorbidity, in later life. However, it remains unclear whether those who were poor in childhood worldwide fall short of healthy aging, as information on childhood conditions is often unreliable. Here, I present new evidence on the lifecourse shaping of healthy aging among older adults worldwide. Methods Some 80,000 older adults aged 50 and over in 32 wealthy and developing nations recalled their childhood conditions at ages 10–14 and then prospectively reported their health functioning. By the decade's end, these countries will host more than half (53%) of the world population aged 60 years and over, according to the United Nations. Following recent empirical studies, a modified healthy aging scale is constructed using a generalized latent trait model. Childhood conditions in England and Europe include the number of books, rooms, and people (indicating overcrowding), the presence of running hot water, and the presence of central heating. Across America, these are mostly replaced with financial hardship or family indebtedness; in China, starvation to death due to government edict; and in Indonesia, the presence of running cold water. As in prior practice, childhood poverty is treated as a latent construct underlying these error-prone recollections. Its associations with the modified healthy aging scale are estimated using country fixed-effects regression, controlling for parental socioeconomic position, age, sex, education, wealth, and marital status. Extensive sensitivity analyses assess robustness. Results and discussion Childhood poverty is associated with reduced healthy aging by 0.14 standard deviations ( z = −17.6); older adults who grew up poor have lower healthy aging scores than those who were not poor. Women reported lower healthy aging scores. Distributions of healthy aging vary across countries, as do age profiles of healthy aging among older adults. Childhood recollections show that those who were poor in childhood enter later life with poorer healthy aging, making the life course shaping of healthy aging central. The strong evidence presented here calls for urgent action to eliminate child poverty, given its lifelong rewards. Researchers can now use childhood recollections from wealthy and developing nations alike to estimate associations with older adults' health. Health policymakers should adopt a life course approach when evaluating childhood health interventions, given their lifelong promise.