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

描述（由申请人提供）：起源家庭的社会经济地位（SES）是可能与慢性病病因学和生存有关的多种多样环境暴露的基本指标。研究表明，儿童时期社会经济地位较低的男性和女性死亡风险增加，与成年后的社会经济特征无关。儿童社会经济地位较低与心血管死亡风险升高之间的联系最为一致。此外，来自社会经济地位较低家庭的男性和女性因呼吸系统和消化系统疾病、糖尿病、吸烟相关癌症、胃癌和肝癌而死亡的人数也有所增加。 然而，现有的研究具有几个局限性。在大多数研究中，早期的社会经济地位是用一种衡量标准来评估的，通常是父亲的教育或职业，通常是回顾性的。此外，很少有研究明确检查性别和种族差异的早期生活SES对死亡率的影响，并在生命历程的途径解释这种影响。最后，儿童SES和成人死亡率之间的中介机制仍不清楚。一个重要的任务是通过采用与生命历程途径的理论重点一致的方法来拓宽生命历程流行病学的方法库。 利用来自威斯康星州纵向研究和健康与退休研究的数据，我将应用考克斯回归和结构方程模型来研究早期生活SES对晚年全因、心血管和癌症死亡率的影响，以及这种影响的性别和种族差异。此外，我建议探讨社会经济特征，婚姻状况和健康行为在成年早期生活SES和晚年死亡率之间的关联的介质。最后，我将分析连接早期社会经济地位和晚年死亡率的因果途径是否以及如何因性别和种族而异。 拟议的研究将提供社会优势和劣势的生命历程轨迹以及这些轨迹按性别和种族/民族的异质性的新证据。此外，探索生命早期社会经济环境与晚年全因和特定原因死亡率之间的联系机制，将提高我们对生命阶段的理解，这些阶段可能对预防工作最重要。

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.