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Lecture

Childhood SES Reading notes

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Department
Health Studies
Course Code
HLTC05H3
Professor
R Song

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Childhood socioeconomic status and adult health Sheldon Cohen,1 Denise Janicki-Deverts1Edith Chen,2 and Karen A. Matthews 3 − Discuss the link 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 1970-2001 o Indiv. From manual childhood social classes were more likely to die from all causes than India. From non-manual social classes o May be due to sick children becoming sick adults in contrast to childhood exposures influencing adult mortality − CASE STUDY: Johns Hopkins University students o Analyzed childhood (CH) SES with health outcomes o Low CH SES caused 2.4-fold increase risk of CHD − CASE STUDY: New Zealand o Indiv. Were followed through their life, CH SES was based on parental occupation o Control 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 o 23% 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 subjects − 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. o Timing model  SES factors have greatest influence on adult health in experience during specific developmental periods  Link between early life SES and adult health depends on identification of sensitive periods (when indiv. Are more vulnerable to SES exposures) o Accumulation model  effects of low SES add up through life  risk for poor adult health increases with increasing intensity of socioeconomic disadvantage and with increasing duration of exposure to such disadvantage.  In contrast to the timing model, the accumulation model is indifferent to when during childhood and adolescence the SES-related exposures occur.  Rather, the accumulation model considers risk in proportion to the total dosage of exposure to SES-related adversities over the course of childhood and adolescence.  the accumulation model predicts that those experiencing low SES throughout both childhood and adolescence are at greater risk for adult morbidity and mortality than are those experiencing low SES during only parts of their childhood or adolescence.  age is totally irrelevant.  The only thing that matters is the magnitude and duration of exposure. o Change Model  direction of SES mobility across childhood and adolescence has implications for adult health outcomes.  upward mobility, a change from lower to higher levels of SES, would result in better adult health.  negative effects of low SES during early childhood would be partly or wholly remediated by higher SES later in childhood or adolescence.  In contrast, downward mobility—a fall in SES over childhood and adolescence —would result in poorer adult health. Introduction − The first decade of twenty-first century marked by several global outbreaks of: SARS, avian influenza, cholera, swine flu, and E coli food poisoning. o Therefore increase in disease surveillance and outbreak investigtion − Traditional epidemiology mainly uses statistical analysis of disease occurrence and health behavious to inform health polity and biomed. interventions. − Visible minorities role play an important role in health outcomes, in the operation of health services, and in health research. − Transmission and reactivation of TB is linked to social conditions of the most socio-economically disadvantaged groups − some infectious diseases operate on two mutually-reinforcing levels st − 1 level interaction o occurs between two or more pathogens resulting in the locational or temporal clustering of certain health problems. o Two or more pathogens can interact on a biochemical and genetic level and accelerate their negative impact on the health of an individual. o Ex. of such synergistic interactions is HIV and TB. o 13 million people living with HIV/AIDS worldwide are co-infected with TB o TB enhances the progression of AIDS o Most common cause of deat
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