Direct and indirect effects of childhood conditions on survival and health among male and female elderly in China

Abstract

This paper investigates whether childhood conditions affect survival and health, both directly and indirectly through the mediating variable of adulthood socioeconomic status, among Chinese elderly. Using data from the 2008–2009 and 2011–2012 waves of the Chinese Longitudinal Healthy Longevity Survey, we apply structural equation models to estimate these effects. We find that favorable childhood conditions exert a negative direct impact on survival probability at senior ages, possibly resulting from mortality selection. Our results also support the pathways model, which indicates that advantageous childhood conditions improve socioeconomic status in adulthood and thus indirectly promote longevity and health at advanced ages. Combining the direct and indirect effects, the total effects of childhood advantages on survival and health are positive. We further demonstrate that direct and indirect effects of childhood conditions are stronger for women than they are for men. Our findings suggest that public policies that target childhood wellbeing may have far-reaching protective impacts on health among seniors.

Effects of Individual, Spousal, and Offspring Socioeconomic Status on Mortality Among Elderly People in China

“…The survey was initiated in 1998 based on a randomly selected sample of older Chinese adults from 22 of the 31 provinces of mainland China, which account for about 85% of the total population of mainland China. 17 The first two surveys mainly targeted those aged 80 years and over, and the younger elderly (aged 65 years and above) were added from the 2002 wave. The method to select younger elderly was similar to that of selecting those aged 80 years and above.…”

“…It is likely that the educational levels of family members will have a stronger association with mortality among the elderly in China than has been observed in other countries because of the commonness of intergenerational co-residence. Several studies have examined the effect of elderly Chinese people’s own socioeconomic status on their mortality risk, 17 , 18 but the extent to which the socioeconomic status of other family members, in particular spouses and children, does or does not affect their mortality is still unclear.…”

Pathways to Health and Well-being

“…Sex differences are also documented, though the emerging picture is not clear. Shen and Zeng (2014) find that the influence of early-life conditions on later health is stronger for women than for men. Quaranta (2014) however finds that the age of mortality cross-over between cohorts that are exposed to adverse early-life conditions versus the unexposed is earlier among men than women, presumably because higher mortality selects the frail faster among men.…”

“…These associations were mostly mediated through adult educational attainment and occupation, suggesting that the indirect effects of childhood conditions were more important than their direct effects. Shen and Zeng (2014) analyse data from the 2008e2009 and 2011e2012 waves of the Chinese Longitudinal Healthy Longevity Survey and apply structural equation modelling to test whether childhood conditions affect late-life survival and health directly or indirectly through their influence on socioeconomic conditions in adulthood. They find that advantageous childhood conditions may improve socioeconomic status in adulthood, and thus indirectly promote longevity at advanced ages.…”

“…At the population level, cohorts that are exposed to adverse conditions early in life may have better health at older ages because the frailer individuals are already deceased. Shen and Zeng (2014) for example, document that favourable childhood conditions are positively related to mortality in senior ages. Quaranta (2014) uses data from Scania in Sweden from the 19th century until the end of the 20th century to analyse how exposure to high disease load in early life is related to later mortality.…”