HLTC05H3 Lecture Notes - Disease Surveillance, Foodborne Illness, Structural Violence
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Childhood socioeconomic status and adult health
Sheldon Cohen,1 Denise Janicki-Deverts,1 Edith Chen,2 and Karen A. Matthews3
−Discuss the link between childhood and adolescent SES and adult health
−explore different environmental, behavioral, and physiological pathways that might explain how early SES
would influence adult health.
−address the ages when SES exposures matter most for setting adult health trajectories
−role of exposure duration in SES influences on later health.
−it is possible that childhood SES does not itself play a role in adult health, but merely represents a
marker of future adult SES
−poorer childhood conditions were not associated with mortality attributable to cancers unrelated to
smoking or to prostate cancer.
−Poorer SES during childhood place indiv. At moderate risk for adult CVD independent of adult SES
−CASE STUDY: Sweden SES data from Census, compared indiv. Born from 1944-1960 and died
oIndiv. From manual childhood social classes were more likely to die from all causes than
India. From non-manual social classes
oMay be due to sick children becoming sick adults in contrast to childhood exposures
influencing adult mortality
−CASE STUDY: Johns Hopkins University students
oAnalyzed childhood (CH) SES with health outcomes
oLow CH SES caused 2.4-fold increase risk of CHD
−CASE STUDY: New Zealand
oIndiv. Were followed through their life, CH SES was based on parental occupation
oControl for perinatal health and adult SES, showed lower CH SES was assoc. with poorer dental hlt
−CASE STUDY: association of early life SES with adult host resistance to cold
o23% got cold, susceptibility to colds decreased in a graded fashion with the number of
childhood years during which participants’ parents owned their homes. This decreased
risk was attributable to both lower risk of infection and lower risk of illness in infected
−access to and affordability of health care is another explanation for the interaction between SES hierarchy
during childhood and adolescence and its affect on adult health
−inverse association between childhood socioeconomic conditions and adult morbidity and mortality
risk has been derived from research conducted in countries that have adopted systems of
nationalized health care such as Sweden, Norway, Finland, Great Britain, Scotland, New Zealand,
and South Korea
−childhood SES Physical environ. mechanisms (psychological/ health behav./ physiological) adult
physical health outcomes
−childhood SES Psychosocial environ. mechanisms (psychological/ health behav) physiolocal adult
physical health outcomes
− Unlike physical exposures, however, psychosocial exposures do not directly influence physiological
mechanisms. Rather, effects are all indirect via psychological factors (e.g., psychological stress,
negative affect) and health related behaviors.
−Prevalence of adult depression increases with decreasing SES
− Early psychosocial exposures associated with lower SES are also thought to alter biological systems
in a manner that can influence health decades later.
− Three broad conceptual models hypothesize when during childhood and adolescence and for what
duration SES related physical and psychosocial exposures have the most important implications for
adult health: timing , accumulation, and change models.
SES factors have greatest influence on adult health in experience during specific
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