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Childhood Socioeconomic Status Predicts Physical Functioning a Half Century Later

¹ Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland.
² Medical Research Council National Survey of Health and Development, Royal Free and University College Medical School, London, United Kingdom.

Address correspondence to Jack M. Guralnik, MD, PhD, National Institute on Aging, 7201 Wisconsin Ave., Room 3C-309, Bethesda, MD 20892. E-mail: jg48s{at}nih.gov

Background. Socioeconomic status (SES) affects health outcomes at all stages of life. Relating childhood socioeconomic environment to midlife functional status provides a life course perspective on childhood factors associated with poor and good health status later in life.

Methods. The British 1946 birth cohort was prospectively evaluated with periodic examinations from birth through age 53 years, when physical performance tests assessing strength, balance, and rising from a chair were administered. Early childhood socioeconomic factors were examined as predictors of low, middle, or high function at midlife. We tested the hypothesis that adulthood behavioral risk factors would explain the childhood SES–midlife physical function associations.

Results. Multiple measures of childhood deprivation were associated with midlife function but in multivariate analyses only father's occupation was associated with low function (relative risk [RR] for manual occupation = 1.6; 95% confidence interval [CI], 1.1–2.3), and only mother's education was associated with high function (RR for lower mother's education = 0.49; 95% CI, 0.34–0.72). Early adulthood behavioral risk factors and middle-age SES and disease status only modestly attenuated the relationship between father's occupation and low function and had no impact on the relationship of mother's education with high function.

Conclusions. The social environment in which a child grows up has a strong association with midlife, objectively measured functional status, which is a reflection of the aging process and chronic diseases accumulated over the life course. Of particular interest is the role of higher maternal education in promoting high midlife functioning.