Childhood Disadvantage and Adult Functional Status: Do Early-Life Exposures Jeopardize Healthy Aging?

OBJECTIVES: To examine whether childhood disadvantage is associated with later-life functional status and identify mediating factors. METHODS: Unique and additive effects of five childhood domains on functional status were assessed at baseline (2006) and over time (2006-2016) in a sample of 13,894 adults from the Health and Retirement Study (>50 years). Adult health behaviors and socioeconomic status (SES) were tested as mediators. RESULTS: Respondents exposed to multiple childhood disadvantages (OR = .694) as well as low childhood SES (OR = .615), chronic diseases (OR = .694), impairments (OR = .599), and risky adolescent behaviors (OR = .608) were less likely to be free of functional disability by baseline. Over time, these unique and additive effects of childhood disadvantage increased the hazard odds of eventually developing functional disability (e.g., additive effect: hOR = 1.261). Adult health behaviors and SES mediated some of these effects. DISCUSSION: Given the enduring effects of childhood disadvantage, policies to promote healthy aging should reduce exposure to childhood disadvantage.

Scientists without borders: lessons from Ukraine.

Conflicts and natural disasters affect entire populations of the countries involved and, in addition to the thousands of lives destroyed, have a substantial negative impact on the scientific advances these countries provide. The unprovoked invasion of Ukraine by Russia, the devastating earthquake in Turkey and Syria, and the ongoing conflicts in the Middle East are just a few examples. Millions of people have been killed or displaced, their futures uncertain. These events have resulted in extensive infrastructure collapse, with loss of electricity, transportation, and access to services. Schools, universities, and research centers have been destroyed along with decades' worth of data, samples, and findings. Scholars in disaster areas face short- and long-term problems in terms of what they can accomplish now for obtaining grants and for employment in the long run. In our interconnected world, conflicts and disasters are no longer a local problem but have wide-ranging impacts on the entire world, both now and in the future. Here, we focus on the current and ongoing impact of war on the scientific community within Ukraine and from this draw lessons that can be applied to all affected countries where scientists at risk are facing hardship. We present and classify examples of effective and feasible mechanisms used to support researchers in countries facing hardship and discuss how these can be implemented with help from the international scientific community and what more is desperately needed. Reaching out, providing accessible training opportunities, and developing collaborations should increase inclusion and connectivity, support scientific advancements within affected communities, and expedite postwar and disaster recovery.

Do Early-Life Social, Behavioral, and Health Exposures Increase Later-Life Arthritis Incidence?

OBJECTIVES: This study investigates direct and indirect influences of childhood social, behavioral, and health exposures on later-life osteoarthritis and rheumatoid arthritis development. METHODS: Drawing from cumulative inequality theory and six waves of the Health and Retirement Study (2004-2014), we estimate structural equation modeling-based discrete-time survival analysis of the association between six childhood exposure domains and both osteoarthritis and rheumatoid arthritis incidence for men (n = 2720) and women (n = 2974). Using the delta method to test for mediation, we examine indirect effects via selected health-related risks and resources. RESULTS: Risky adolescent behavior is associated with rheumatoid arthritis incidence for women (h.O.R. = 1.883, 95% C.I. [1.016, 3.490]), whereas several types of childhood exposures are associated with later-life osteoarthritis development for both men and women. Experiencing two or more childhood socioeconomic disadvantages is indirectly associated with osteoarthritis (men: coef. = 0.024, 95% C.I. [0.003, 0.045]; women: coef. = 0.111, 95% C.I. [0.071, 0.150]) and rheumatoid arthritis (men: coef. = 0.037, 95% C.I. [0.000, 0.074]; women: coef. = 0.097, 95% C.I. [0.035, 0.159]) development through adult body mass index. DISCUSSION: Findings highlight the importance of childhood contexts in understanding the development of later-life osteoarthritis and rheumatoid arthritis.

Early Social Origins of Biological Risks for Men and Women in Later Life.

We investigate whether childhood exposures influence adult chronic inflammation and mortality risk via adult health characteristics and socioeconomic status (SES) and whether gender moderates these relationships. Analyzing a longitudinal national sample of 9,310 men and women over age 50, we found that childhood SES, parental behaviors, and adolescent behaviors were associated with adult chronic inflammation via health characteristics and SES in adulthood. The process of disadvantage initiated by low childhood SES (i.e., adult health risk factors, socioeconomic disadvantage, and chronic inflammation) subsequently raised mortality risk. In addition, gender moderated the mediating influence of childhood SES via unhealthy behaviors and parental behaviors via adult SES. Demonstrating how social forces shape biological health through multiple mechanisms informs health policies by identifying multiple points of intervention in an effort to reduce the lasting consequences of childhood disadvantage.

Human-mediated disturbance in multitrophic interactions results in outbreak levels of North America's most venomous caterpillar.

Anthropogenic environmental change is predicted to disrupt multitrophic interactions, which may have drastic consequences for population-level processes. Here, we investigate how a large-scale human-mediated disturbance affects the abundance of North America's most venomous caterpillar species, Megalopyge opercularis. Specifically, we used a natural experiment where netting was deployed to cover the entire canopies of a subset of mature southern live oak trees (Quercus virginiana) to exclude urban pest birds (grackles and pigeons), throughout an 8.1 km2 area encompassing a medical centre in Houston, Texas. We used this experimental exclusion to test the following hypothesis: release from avian predators increases caterpillar abundance to outbreak levels, which increases the risk to human health. Results from a multi-year survey show that caterpillar abundance increased, on average, more than 7300% on netted versus non-netted trees. Thus, increases in caterpillar abundance due to anthropogenic enemy release increase human exposure to this venomous pest, and should be considered a health threat in the area. This study emphasizes the unforeseen consequences of ecological disturbance for species interactions and highlights the importance of considering ecology in urban planning.

Childhood Misfortune and Handgrip Strength Among Black, White, and Hispanic Americans.

OBJECTIVE: Although early-life insults may affect health, few studies use objective physical measures of adult health. This study investigated whether experiencing misfortune during childhood is associated with handgrip strength (HGS) in later life. METHOD: Data on childhood misfortune and adult characteristics from the Health and Retirement Study were used to predict baseline and longitudinal change in HGS among White, Black, and Hispanic American men and women. RESULTS: Regression analyses revealed that multiple indicators of childhood misfortune were related to HGS at baseline, but the relationships were distinct for men and women. Over the study, having one childhood impairment predicted steeper declines in HGS for men, but childhood misfortune was unrelated to HGS change among women. Hispanic Americans had lower baseline HGS than their non-Hispanic counterparts and manifested steeper declines in HGS. DISCUSSION: The relationship between childhood exposures and adult HGS varied by the type of misfortune, but there was no evidence that the relationship varied by race/ethnicity. The significant and enduring Hispanic disadvantage in HGS warrants greater attention in gerontology.

Does Early-Life Misfortune Increase the Likelihood of Psychotropic Medication Use in Later Life?

Life-course research has linked childhood experiences to adult mental illness, but most studies focus on anxiety or depressive symptoms, which may be transient. Therefore, this study investigates whether childhood misfortune is associated with taking psychotropic medication, a measure reflecting an underlying chronic mental disorder. Data are from three waves of a national survey of 2,999 U.S. men and women aged 25-74 years. Four domains of childhood misfortune (childhood socioeconomic status, family structure, child maltreatment, and poor health) are considered-specified as separate domains and a single additive measure-as key predictors of psychotropic medication use. Findings reveal an association between additive childhood misfortune and adult psychotropic medication use, net of adult risk factors. Psychotropic medication use is also more likely during the 20-year study for adults who experienced maltreatment and poor health during childhood. These results reveal the importance of early intervention to reduce consumption of psychotropic medications and associated costs.

Early Origins of Adult Cancer Risk Among Men and Women: Influence of Childhood Misfortune?

OBJECTIVE: To examine the effect of five childhood misfortune domains-parental behavior, socioeconomic status, infectious diseases, chronic diseases, and impairments-on all-site and selected site-specific cancer prevalence and all-site cancer incidence. METHOD: Panel data from the Health and Retirement Study (2004-2012) were used to investigate cancer risk among adults above the age of 50. RESULTS: Risky parental behavior and impairment in childhood were associated with higher odds of all-site cancer prevalence, and childhood chronic disease was associated with prostate cancer, even after adjusting for adult health and socioeconomic factors. Moreover, having one infectious disease in childhood lowered the odds of colon cancer. Cancer trends varied by race and ethnicity, most notably, higher prostate cancer prevalence among Black men and lower all-site cancer among Hispanic adults. DISCUSSION: These findings underscore the importance of examining multiple domains of misfortune because the type and amount of misfortune influence cancer risk in different ways.

What Do We Mean by Accumulation? Advancing Conceptual Precision for a Core Idea in Gerontology.

In recent decades, the concept of accumulation has gained prominence in research on aging, health, and social stratification. Accumulation is now studied in multiple disciplines, revealing that cumulative processes are crucial to understanding patterns of differentiation over the life course. Although this research has demonstrated the empirical value of studying accumulation, the concept has taken on different and sometimes inconsistent meanings. To address these inconsistencies, we propose an interdisciplinary conceptual framework of accumulation that focuses on objects, timing, thresholds, de-accumulation, and the levels and consequences of accumulation. Providing a coherent framework of accumulation will aid conceptual precision, guide future research, and inform public policies related to aging and the life course.

Childhood Misfortune, Personality, and Heart Attack: Does Personality Mediate Risk of Myocardial Infarction?

Objective: Previous research has revealed a link between childhood experiences and adult health, but the mechanisms underlying this relationship are less clear. To elucidate this relationship, we investigated the pathway from childhood misfortune to nonfatal myocardial infarction (MI) via individual differences in personality. Method: Longitudinal data were drawn from the National Survey of Midlife Development in the United States, which sampled 3,032 men and women aged 25-74 years at baseline. Big 5 personality traits and multiple measures of childhood misfortune were used to assess whether personality mediated the effect of childhood misfortune on MI risk. Results: A series of proportional hazards models revealed that neuroticism mediated the effect of additive childhood misfortune on adult MI risk. Discussion: Childhood misfortune may be formative in the development of personality, which, subsequently, can be consequential to health. These findings highlight the salient roles of early-life experiences and personality to shape health and aging.

Why do older people change their ratings of childhood health?

A growing number of studies in life course epidemiology and biodemography make use of a retrospective question tapping self-rated childhood health to assess overall physical health status. Analyzing repeated measures of self-rated childhood health from the Health and Retirement Study (HRS), this study examines several possible explanations for why respondents might change their ratings of childhood health. Results reveal that nearly one-half of the sample revised their rating of childhood health during the 10-year observation period. Whites and relatively advantaged older adults-those with more socioeconomic resources and better memory-were less likely to revise their rating of childhood health, while those who experienced multiple childhood health problems were more likely to revise their childhood health rating, either positively or negatively. Changes in current self-rated health and several incident physical health problems were also related to the revision of one's rating of childhood health, while the development of psychological disorders was associated with more negative revised ratings. We then illustrate the impact that these changes may have on an adult outcomes: namely, depressive symptoms. Whereas adult ratings of childhood health are likely to change over time, we recommend their use only if adjusting for factors associated with these changes, such as memory, psychological disorder, adult self-rated health, and socioeconomic resources.

Does childhood misfortune raise the risk of acute myocardial infarction in adulthood?

Whereas most research on acute myocardial infarction (AMI) has focused on more proximal influences, such as adult health behaviors, the present study examines the early origins of AMI. Longitudinal data were drawn from the National Survey of Midlife Development in the United States (N = 3032), a nationally representative survey of men and women aged 25-74, which spans from 1995 to 2005. A series of event history analyses modeling age of first AMI investigated the direct effects of accumulated and separate domains of childhood misfortune as well as the mediating effects of adult health lifestyle and psychosocial factors. Findings reveal that accumulated childhood misfortune and child maltreatment increased AMI risk, net of several adult covariates, including family history of AMI. Smoking fully mediated the effects of both accumulated childhood misfortune and child maltreatment. These findings reveal the importance of the early origins of AMI and health behaviors as mediating factors.

Child maltreatment and adult health in a national sample: heterogeneous relational contexts, divergent effects?

OBJECTIVE: This study considers the long-term health consequences of child maltreatment. Distinct from previous research, we examine the effects of maltreatment in the context of more general parental evaluations. METHOD: Analyses used retrospective and current data from the Midlife Development in the United States (MIDUS) study. RESULTS: A considerable proportion of middle- and older-age adults who experienced frequent maltreatment nevertheless evaluated the relationship with their offending parent as "excellent", "very good", or "good" (e.g., 47% for physical and emotional maltreatment by mothers). Maltreated respondents generally evaluated their maltreating parents less favorably than non-maltreating parents, but there was considerable variation in these recollected relationships. Adults who experienced child maltreatment reported a greater number of chronic medical conditions and physical symptoms and lower self-rated health, but effects were smaller when they had positive relationships with their parents than when one or more of the relationships was perceived as negative. CONCLUSIONS: These findings highlight a common and seemingly paradoxical pattern among MIDUS participants: the co-presence of harsh parental behavior and positive recollections of parental relationships during childhood. Moreover, these surprising patterns of retrospective interpretation predict very different experiences of adult health - health problems are most pronounced among maltreatment in cases where the respondent had a generally negative relationship with one or more of his or her parents.

Does childhood misfortune increase cancer risk in adulthood?

OBJECTIVE: To address the inconsistent findings on whether childhood misfortune increases adult cancer occurrence. METHODS: This study uses longitudinal data from the National Survey of Midlife Development in the United States (MIDUS) that first sampled 3,032 respondents aged 25 to 74 during 1995-1996. A series of logistic regressions were estimated separately for men and women to test whether the effect of childhood misfortune on adult cancer was largely cumulative or specific to the type or profile of misfortune. RESULTS: For men, additive childhood misfortune, physical abuse by father, and frequent abuse by either parent increased cancer risk. For women, physical abuse by mother and frequent abuse by either parent increased cancer risk. DISCUSSION: Analyses revealed the importance of examining alternative specifications of childhood misfortune for men and women. Additive childhood misfortune predicted cancer for men only, whereas child abuse by parent of the same sex predicted cancer for men and women.

Prospective surveillance of excess mortality due to influenza in New South Wales: feasibility and statistical approach.

Influenza is a serious disease that seasonally causes varying but substantial morbidity and mortality. Therefore, strong, rapid influenza surveillance systems are a priority. Surveillance of the population mortality burden of influenza is difficult because few deaths have laboratory confirmation of infection. Serfling developed a statistical time series model to estimate excess deaths due to influenza. Based on this approach we trialled weekly monitoring of excess influenza mortality. Weekly, certified death information was loaded into a database and aggregated to provide a time series of the proportion of all deaths that mention pneumonia or influenza on the death certificate. A robust regression model was fitted to the time series up to the end of the previous calendar year and used to forecast the current year's mortality. True and false alarm rates were used to assess the sensitivity and specificity of alternative thresholds signifying excess mortality. Between 1 January 2002 and 9 November 2007, there were 279,968 deaths registered in New South Wales, of which 77% were among people aged 65 years or more. Over this period 33,213 (12%) deaths were classified as pneumonia and influenza. A threshold of 1.2 standard deviations highlighted excess mortality when influenza was circulating while providing an acceptable false alarm rate at other times of the year. Prospective and reasonably rapid monitoring of excess mortality due to influenza in an Australian setting is feasible. The modelling approach allows health departments to make a more objective assessment of the severity of seasonal influenza and the effectiveness of mitigation strategies.