Childhood Socioeconomic Status and Late-Life Mortality: Sex and Race Differences

童年社会经济地位和晚年死亡率：性别和种族差异

• 批准号: 8147604
• 负责人: Tetyana Pudrovska
• 金额: $ 6.11万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8147604
• 关键词: Address; Adult; Awareness; Cardiovascular system; Cause of Death; Characteristics; Childhood; Chronic; Chronic Disease; Complex; Data; Diabetes Mellitus; Digestive System Disorders; Disadvantaged; Disease; Education; Elderly; Environment; Environmental Exposure; Epidemiology; Equation; Ethnic Origin; Etiology; Family; Fathers; Gender; Health; Health behavior; Heart Diseases; Heterogeneity; Life; Life Cycle Stages; Life Style; Link; Logistic Regressions; Longitudinal Studies; Longitudinal Surveys; Lung diseases; Malignant Neoplasms; Malignant neoplasm of liver; Marital Status; Measures; Mediating; Mediator of activation protein; Methods; Modeling; Morality; Occupations; Outcome; Pathway interactions; Prevention; Preventive Intervention; Public Health; Publications; Race; Research; Research Personnel; Resources; Retirement; Risk; Sex Characteristics; Smoking; Socioeconomic Status; Staging; Structural Models; Testing; Time; Wisconsin; Woman; cardiovascular risk factor; improved; low socioeconomic status; malignant stomach neoplasm; men; mortality; racial difference; social; socioeconomics

DESCRIPTION (provided by applicant): Socioeconomic status (SES) of the family of origin is a fundamental indicator of multiple and diverse environmental exposures that might be implicated in chronic disease etiology and survival. Research indicates that men and women with lower SES during childhood have an increased risk of mortality, independent of their socioeconomic characteristics in adulthood. The most consistent link has been established between lower childhood SES and an elevated risk of cardiovascular mortality. In addition, men and women from lower-SES families of origin have elevated mortality from respiratory and digestive diseases, diabetes, smoking-related cancers, and stomach and liver cancers. Yet existing research is characterized by several limitations. In most studies, early-life SES was assessed with one measure, typically fathers' education or occupation, often retrospectively. Moreover, few studies have explicitly examined gender and race differences in the effect of early-life SES on mortality and in the life course pathways explaining this effect. Finally, the mediating mechanisms linking childhood SES and adult mortality remain unclear. An important task is to broaden the methodological arsenal of life course epidemiology by employing methods that are consistent with the theoretical emphasis on life course pathways. Using data from the Wisconsin Longitudinal Study and the Health and Retirement Study, I will apply Cox regression and structural equation modeling to examine the effect of early-life SES on all-cause, cardiovascular, and cancer morality in later life as well as gender and race differences in this effect. Further, I propose to explore socioeconomic characteristics, marital status, and health behaviors in adulthood as mediators of the associations between early-life SES and late-life mortality. Finally, I will analyze whether and how causal pathways linking early-life SES and later-life mortality differ by gender and race. The proposed study will provide new evidence of life course trajectories of social advantage and disadvantage and heterogeneity of these trajectories by gender and race/ethnicity. Moreover, the exploration of mechanisms linking early-life socioeconomic environment to all-cause and cause-specific mortality in later life will improve our understanding of life stages that may be potentially the most important for prevention efforts. PUBLIC HEALTH RELEVANCE: The proposed study has potentially important public health implications. The exploration of causal mechanisms linking early-life socioeconomic environment to all-cause and cause-specific mortality in later life will improve our understanding of life stages that may be potentially the most important for prevention efforts. Because early-life socioeconomic conditions exert their influence on mortality over a long time span, they are more amenable than contemporaneous conditions in adulthood to preventive interventions between childhood and the manifestation of the disease.

描述(由申请人提供)：原籍家庭的社会经济地位(SES)是可能与慢性病病因学和存活率有关的多种不同环境暴露的基本指标。研究表明，儿童期SES较低的男性和女性死亡的风险增加，与他们成年后的社会经济特征无关。在儿童时期较低的SES和较高的心血管死亡风险之间已经建立了最一致的联系。此外，来自低社会经济地位家庭的男性和女性死于呼吸系统和消化系统疾病、糖尿病、与吸烟有关的癌症以及胃癌和肝癌的死亡率较高。然而，现有研究的特点是有几个局限性。在大多数研究中，早期的SES是通过一种衡量标准进行评估的，通常是父亲的教育或职业，通常是回溯性的。此外，很少有研究明确研究性别和种族差异对早期SES对死亡率的影响，以及在解释这种影响的生命过程中的差异。最后，儿童SES和成人死亡率之间的中介机制仍不清楚。一项重要的任务是通过采用与生命过程途径的理论强调一致的方法来拓宽生命过程流行病学的方法论武器库。使用来自威斯康星州纵向研究和健康与退休研究的数据，我将应用COX回归和结构方程模型来检验早期SES对晚年全因、心血管和癌症道德的影响，以及性别和种族差异对这种影响的影响。此外，我建议探索社会经济特征、婚姻状况和成年后的健康行为，作为早期生活自尊和晚年死亡率之间的中介变量。最后，我将分析性别和种族是否以及如何将早期自闭症和晚期死亡率之间的因果关系联系起来。拟议的研究将按性别和种族/族裔提供关于社会优势和劣势的人生轨迹以及这些轨迹的异质性的新证据。此外，探索将早期社会经济环境与晚年全因和特定原因死亡率联系起来的机制，将提高我们对可能是预防工作最重要的生命阶段的理解。 公共卫生相关性：拟议的研究具有潜在的重要公共卫生影响。探索将早期社会经济环境与晚年全因和特定原因死亡联系起来的因果机制将提高我们对生命阶段的理解，这些阶段可能是预防工作最重要的阶段。由于早期的社会经济状况在很长一段时间内对死亡率产生影响，它们比成年期的同期状况更容易受到儿童时期和疾病表现之间的预防性干预。