Economic hardship in childhood and adult health trajectories: An alternative approach to investigating life-course processes

Abstract

In this study, we advance existing research on health as a life course process by conceptualizing and measuring both childhood disadvantage and health as dynamic processes in order to investigate the relationship between trajectories of early life socioeconomic conditions and trajectories of health in midlife. We utilize a trajectory-based analysis that takes a disaggregated, person-centered approach to understand dynamic trajectories of health as latent variables that reflect the timing, duration and change in health conditions experienced by respondents over a period of 10 years in midlife as a function of stability and change in exposure to economic hardship in early life. Results from repeated-measures latent class analysis of longitudinal data from the Panel Study of Income Dynamics indicate that economic hardship in childhood has long-term, negative consequences for health both among individuals beginning life and remaining in poverty as well as those moving into poverty. In contrast, adults with more advantaged early life experiences, or who moved out of poverty during the period of observation, were at a lower risk of experiencing health trajectories characterized by the early onset or increasing risk of disease. We argue that a person-centered, disaggregated approach to the study of the relationship between socioeconomic status and health across the life course holds potential for the study of health inequality and that a greater focus on trajectory-based analysis is needed.

Heterogeneity in chronic disease outcomes among women and men in midlife: examining the role of stability and change in childhood economic hardship

“…For example, long-term exposure to childhood disadvantage appears to have the strongest negative effect on adult achievement outcomes and is harmful to health in adulthood (e.g., Shuey & Willson, 2014;Wagmiller et al, 2006). However, research also suggests that transitions into or out of sustained poverty in childhood have distinct effects on health.…”

“…Early life inequalities in socioeconomic environment are thought to initiate processes of cumulative advantage and disadvantage which lead to divergent trajectories of health across the life course (Corna, 2013). Research also indicates that the timing, duration, and sequencing of childhood exposure to economic hardship are critical for many adulthood outcomes, including health (Shuey & Willson, 2014;Wagmiller, Lennon, Kuang, Alberti & Aber, 2006). Existing models of cumulative dis/advantage, however, differentially emphasise the importance of each temporal complexity (see Shuey & Willson, 2014, for a review).…”

“…However, research also suggests that transitions into or out of sustained poverty in childhood have distinct effects on health. For example, deteriorating health in mid-life is more likely among those who transition into sustained economic hardship in childhood, while those whose families move out of poverty during childhood have health trajectories similar to those who never faced economic hardship (Shuey & Willson, 2014). Accordingly, the timing and duration of experiences of disadvantage in childhood are important to understanding life course trajectories of health.…”

“…Research also indicates that the timing, duration, and sequencing of childhood exposure to economic hardship are critical for many adulthood outcomes, including health (Shuey & Willson, 2014;Wagmiller, Lennon, Kuang, Alberti & Aber, 2006). Existing models of cumulative dis/advantage, however, differentially emphasise the importance of each temporal complexity (see Shuey & Willson, 2014, for a review). Such approaches also do not take into account heterogeneity in childhood circumstances, ignoring the way in which socioeconomic circumstances can improve or deteriorate throughout childhood, as well as issues of timing related to the onset of disadvantage.…”

“…In other words, the relationship between socioeconomic resources and health begins in early life and is magnified over time. Widening health disparities between advantaged and disadvantaged groups with age suggest that processes of cumulative dis/advantage operate across the life course (Brown, O'Rand, & Adkins, 2012; Nicole Etherington, Andrea Willson, Kim Shuey Heterogeneity in chronic disease outcomes among women and men in midlife… Dupre, 2007;Lynch, 2003;Shuey & Elder, 2008;Shuey & Willson, 2014;Willson et al, 2007). Early life inequalities in socioeconomic environment are thought to initiate processes of cumulative advantage and disadvantage which lead to divergent trajectories of health across the life course (Corna, 2013).…”