Childhood socioeconomic position and healthy ageing: results from five harmonised cohort studies in the ATHLOS consortium.

Abstract

Introduction: Childhood socioeconomic position (SEP) has been identified as a key determinant of health. However, earlier literature is largely from high-income countries and provides limited evidence on the prolonging impacts of childhood disadvantage on healthy ageing across diverse settings and populations. The aim of this study is to investigate the associations between childhood SEP and healthy ageing across multiple countries and the mediation effects of adult SEP, individual education and wealth, on these associations.

Methods: Using the harmonised dataset of five cohort studies in the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, this study was based on 57 956 people aged ≥50 years (women: 53.3%) living in China, Finland, UK, Poland, South Africa and Mexico. The associations between childhood SEP (parental education and occupation) and healthy ageing scores were examined using linear regression modelling. Causal mediation analysis was carried out to estimate the percentage of indirect effects via adult SEP (individual education and wealth).

Results: Higher levels of childhood SEP were associated with higher healthy ageing scores by up to five points and similar patterns were observed across populations from different countries. The associations were mediated by adult SEP and the range of mediation effects was between 21% and 78%.

Conclusions: This study found childhood SEP was associated with poor health in later life across high-income, middle-income and low-income countries. Addressing socioeconomic disadvantage, such as improving education attainment, may moderate the impacts of adversity in early life and support health and functioning in later life.