Life-course pathways from childhood socioeconomic status to type 2 diabetes in mid-late Chinese adulthood

Abstract

The relationship between childhood socioeconomic status (SES) and type 2 diabetes (T2D) remains inconclusive, and the pathways and mechanisms driving this relationship have yet to be clarified. This study aimed to examine the pathways linking childhood SES to T2D prevalence in mid-late adulthood in a low- and middle-income country. The incidence of T2D diagnosed in mid-late Chinese adulthood was assessed using self-reports from the Health and Retirement Longitudinal Study (CHARLS). Childhood SES was assessed by the education, occupation, survivorship of the parents and the financial situation of the family, whereas adulthood SES was assessed by education and wage. This study performed structural equation modeling to clarify the direct and indirect pathways from childhood SES to T2D via childhood health, childhood food shortage, adulthood SES and physical activity. A total of 15,132 participants were included, and the prevalence of T2D was 5.24%. This study found that childhood SES was directly associated with T2D in mid-late adulthood, the probability of developing T2D increased by 9.20% of the standard deviation for each decrease in standard deviation in childhood SES. Childhood SES was indirectly associated with T2D via adulthood SES, physical activity, childhood health and food shortage. Adulthood SES and physical activity mainly mediated the indirect pathway from childhood SES and T2D. This study showed direct and indirect pathways from disadvantaged childhood SES to increased risk of T2D in mid-late Chinese adulthood. Childhood SES, adulthood SES, physical activity, childhood health and food shortage were identified as life-course interventional targets that should be considered in the development of effective strategies to reduce the burden of T2D and SES-related health inequities in childhood.

Re-examining the reversal hypothesis: A nationwide population-based study of the association between socioeconomic status, and NCDs and risk factors in China

“…We also need to consider more complex processes in the emergence of NCDs. We know that early-life disadvantages such as low family and parental SES, or bad health in infancy and childhood ( Ding et al, 2021 ; McEniry, 2013 ; Ogunsina et al, 2018 ; Zhang et al, 2021 ), have significant impacts on health in adulthood and old age. Participants in our study were aged from 45 to 115, with birth years spanning from 1900 to 1970, and 68% of them were 45–64 years old (born between 1951 and 1970).…”

The impact of family function on mental health status in patient with inflammatory bowel disease: The mediating role of self-esteem

“…Patients may thus find their families to be the most accessible source of social support. Research has demonstrated that flourishing family functioning can enhance patient self-efficacy, increase positive coping strategies, and reduce negative psychological states ( 11 , 12 ). Thus, the family function may be a protective factor for the prognosis of IBD patients, influencing their mental and physical health.…”

A Lifelong Perspective for Cognitive Health in Old Age

“…In contrast to the APOE 4 genotype, which is not modifiable, higher education and intellectually and physically active lifestyles are amenable to improvements. Not only do these factors contribute to cognitive reserve but they have also been linked to reduced risk for other major diseases of aging, including hypertension, 3 type 2 diabetes, 4 and stroke, 5 also known as risk factors for the development of dementia. The Lancet Commission on Dementia Prevention, Intervention, and Care estimated that a third of cases of dementia are potentially preventable with interventions aimed to increase childhood education, exercise, socialization, smoking cessation, management of hearing loss, depression, diabetes, hypertension, and obesity.…”