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Association between childhood life circumstances and chronic diseases in middle-aged and elderly individuals: A
Liyong Lu1, Sicheng Li2, Ting Chen3
1Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China.
Insights
Childhood life circumstances significantly impact adult chronic diseases. Parental deformity was the most influential childhood factor, affecting later-life health outcomes in middle-aged and older adults.
Area of Science:
- Public Health
- Epidemiology
- Gerontology
Background:
- Childhood conditions like socioeconomic status, trauma, and adverse experiences are linked to later-life health.
- However, the impact of numerous other childhood life circumstances on chronic disease development remains underexplored.
Purpose of the Study:
- To investigate the association between various childhood life circumstances and the prevalence of chronic diseases in middle-aged and elderly individuals.
- To identify specific childhood factors and their relative importance in predicting adult chronic disease status.
Main Methods:
- Utilized data from the China Health and Retirement Longitudinal Study (CHARLS) (2011-2020) with 16,681 participants.
- Examined 50 childhood life circumstance factors across six domains, employing logistic regression, LASSO, and quantile g-computation (QGC).
- K-Means clustering identified distinct subpopulations based on childhood circumstances to analyze differential chronic disease susceptibility.
Main Results:
- Over 71.36% of participants reported chronic diseases.
- 17 out of 50 childhood factors showed a significant positive association with chronic diseases.
- Parental deformity was the most significant contributor to chronic disease development, explaining 23.50% of the variance via QGC.
Conclusions:
- Childhood life circumstances have a lasting impact on adult chronic disease development.
- Parental deformity is the most influential childhood factor identified.
- The most disadvantaged subpopulation experienced childhood health issues, wartime exposure, and parental health problems, indicating higher chronic disease risk.
Objective:
Previous research has explored the links between later-life health and various childhood conditions, such as socioeconomic status, adverse childhood experiences, and trauma. However, numerous other childhood life circumstances and their relative significance have yet to be examined. This study investigated the association between childhood life circumstance factors and chronic diseases among middle-aged and elderly individuals.
Method:
Participants were sourced from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide survey spanning 2011 to 2020. This study utilized 42,181 observations from 16,681 middle-aged and older adults, averaging around 60 years of age. Females constituted 58.12% of the sample. We examined 50 life circumstance factors across six domains: childhood socioeconomic status, wartime experiences during childhood, childhood health, childhood trauma, childhood relationships, and parental health. Data on these factors were derived from CHARLS's 2014 life history survey, alongside chronic disease and demographic information obtained from baseline surveys in 2011 and subsequent follow-ups through 2020. Chronic disease status relied on self-reported physician diagnoses. Logistic regression was employed to investigate the association between childhood life circumstance factors and adult chronic disease status. The study utilized the Least Absolute Shrinkage and Selection Operator (LASSO) method to identify significant factors, followed by quantile g-computation (QGC) to assess their relative importance. Additionally, the K-Means cluster method was used to categorize individuals based on similar childhood life circumstances, exploring susceptibility to chronic diseases within these subpopulations using logistic regression, LASSO, and QGC analyses.
Results:
Of the 42,181 observations from 16,681 middle-aged and older adults, over 71.36% reported chronic diseases. Out of the 50 childhood life circumstance factors examined, 17 were found to have a statistically significant positive association with chronic diseases. LASSO identified 20 factors with non-zero coefficients, with parental deformity emerging as the most significant contributor to chronic disease development, accounting for 23.50% of the variance according to QGC. Four distinct subpopulations were identified, with Subpopulation 1 representing the most disadvantaged group.
Conclusions:
Our findings underscored the enduring impact of childhood life circumstances on chronic disease development later in life, with parental deformity identified as the most influential childhood factor. The most disadvantaged subpopulation includes individuals with higher prevalence of health problems during childhood, born during wartime, and with parents having a history of health issues.
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