Tracing the origins of successful aging: the role of childhood conditions and social inequality in explaining later life health.

This study investigates the role of childhood conditions and social inequality in older Europeans' propensity to age successfully, controlling for later life risk factors. Successful aging was assessed following Rowe and Kahn's conceptualization, using baseline interviews from the first two waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). These data were merged with retrospective information on participants from 13 Continental European countries, collected as part of the SHARELIFE project. Our sample consists of 22,464 men and women, who are representative of the non-institutionalized population aged 50 or older (mean age: 63.3) in their respective country. Estimating multilevel logistic models, we controlled for demographics (age, sex), childhood conditions (SES, health, cognition), later life risk factors (various dimensions of SES and health behaviors), as well as social inequality (measured by country-specific Gini coefficients). There is an independent association of childhood living conditions with elders' odds of aging well. Higher parental SES, better math and reading skills, as well as self-reports of good childhood health were positively associated with successful aging, even if contemporary characteristics were controlled for. Later life SES and health behaviors exhibited the expected correlations with our dependent variable. Moreover, lower levels of income inequality were associated with a greater probability of meeting Rowe and Kahn's successful aging criteria. We conclude that unfavorable childhood conditions exhibit a harmful influence on individuals' chances to age well across all European welfare states considered in this study. Policy interventions should thus aim at improving the conditions for successful aging throughout the entire life course.

[1]  J. Roberts,et al.  Successful aging in the United States: prevalence estimates from a national sample of older adults. , 2010, The journals of gerontology. Series B, Psychological sciences and social sciences.

[2]  A. Börsch-Supan,et al.  Longitudinal Data Collection in Continental Europe : Experiences from the Survey of Health, Ageing and Retirement in (SHARE) , 2008 .

[3]  K. Hank How "successful" do older Europeans age? Findings from SHARE. , 2011, The journals of gerontology. Series B, Psychological sciences and social sciences.

[4]  B. Soldo,et al.  Do early-life conditions predict functional health status in adulthood? The case of Mexico. , 2011, Social science & medicine.

[5]  H. Koenig,et al.  Rowe and Kahn's model of successful aging revisited: positive spirituality--the forgotten factor. , 2002, The Gerontologist.

[6]  I. Kawachi,et al.  Income inequality, mortality, and self rated health: meta-analysis of multilevel studies , 2009, BMJ : British Medical Journal.

[7]  J. Hox,et al.  Sufficient Sample Sizes for Multilevel Modeling , 2005 .

[8]  Ming Wen,et al.  The Effects of Childhood, Adult, and Community Socioeconomic Conditions on Health and Mortality among Older Adults in China , 2011, Demography.

[9]  T. Hatton,et al.  Childhood Economic Conditions and Length of Life: Evidence from the UK Boyd Orr Cohort, 1937-2005 , 2007, Journal of health economics.

[10]  Ichiro Kawachi,et al.  Income inequality and health: what have we learned so far? , 2004, Epidemiologic reviews.

[11]  I. Kawachi Commentary: social capital and health: making the connections one step at a time. , 2006, International journal of epidemiology.

[12]  R. Wilkinson,et al.  Income inequality and population health: a review and explanation of the evidence. , 2006, Social science & medicine.

[13]  J. Lynch,et al.  Childhood socioeconomic circumstances and cause-specific mortality in adulthood: systematic review and interpretation. , 2004, Epidemiologic reviews.

[14]  B. Gorman,et al.  The long arm of childhood: The influence of early-life social conditions on men’s mortality , 2004, Demography.

[15]  Ichiro Kawachi,et al.  Whose health is affected by income inequality? A multilevel interaction analysis of contemporaneous and lagged effects of state income inequality on individual self-rated health in the United States. , 2006, Health & place.

[16]  M. Myrskylä,et al.  Income inequality and population health: a panel data analysis on 21 developed countries , 2011 .

[17]  Jenifer Hamil-Luker,et al.  Processes of cumulative adversity: childhood disadvantage and increased risk of heart attack across the life course. , 2005, The journals of gerontology. Series B, Psychological sciences and social sciences.

[18]  G. Kempen,et al.  Cross-cultural comparison between academic and lay views of healthy ageing: a literature review , 2010, Ageing and Society.

[19]  R. Swift The relationship between health and GDP in OECD countries in the very long run. , 2011, Health economics.

[20]  W. Strawbridge,et al.  Successful aging and well-being: self-rated compared with Rowe and Kahn. , 2002, The Gerontologist.

[21]  K. Ferraro,et al.  Childhood misfortune as a threat to successful aging: avoiding disease. , 2012, The Gerontologist.

[22]  Andrew Gelman,et al.  Data Analysis Using Regression and Multilevel/Hierarchical Models , 2006 .

[23]  Steven A. Haas The long-term effects of poor childhood health: An assessment and application of retrospective reports , 2007, Demography.

[24]  R. Layte The Association Between Income Inequality and Mental Health: Testing Status Anxiety, Social Capital, and Neo-Materialist Explanations , 2012 .

[25]  A. Efklides,et al.  LAY CONCEPT OF AGING WELL: CROSS‐CULTURAL COMPARISONS , 2008, Journal of the American Geriatrics Society.

[26]  Angus Deaton,et al.  Health, Inequality, and Economic Development , 2001 .

[27]  D. Gu,et al.  Early life influences on cognitive impairment among oldest old Chinese. , 2008, The journals of gerontology. Series B, Psychological sciences and social sciences.

[28]  M. Rose,et al.  Successful aging: early influences and contemporary characteristics. , 2010, The Gerontologist.

[29]  S. Dube,et al.  The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. , 2003, Preventive medicine.

[30]  B. Pfau-Effinger Culture and Welfare State Policies: Reflections on a Complex Interrelation , 2004, Journal of Social Policy.

[31]  Karsten Hank,et al.  Societal Determinants of Productive Aging: A Multilevel Analysis across 11 European Countries , 2011 .

[32]  Hiram Beltrán-Sánchez,et al.  Mortality and morbidity trends: is there compression of morbidity? , 2011, The journals of gerontology. Series B, Psychological sciences and social sciences.

[33]  J. Rowe,et al.  Successful aging. , 1998, Aging.

[34]  Guang Guo,et al.  Multilevel Modeling for Binary Data , 2000 .

[35]  Omar Paccagnella,et al.  Income, wealth and financial fragility in Europe , 2009 .

[36]  Ye Luo,et al.  The impact of childhood and adult SES on physical, mental, and cognitive well-being in later life. , 2005, The journals of gerontology. Series B, Psychological sciences and social sciences.

[37]  G. Fitzmaurice,et al.  Socioeconomic status in childhood and the lifetime risk of major depression. , 2002, International journal of epidemiology.

[38]  Sue Waddington,et al.  A memorandum on lifelong learning , 2000 .

[39]  M. Lindeboom,et al.  Inequality in Individual Mortality and Economic Conditions Earlier in Life , 2004, Social science & medicine.

[40]  James P. Smith,et al.  From Angela's Ashes to the Celtic Tiger: Early Life Conditions and Adult Health in Ireland , 2011, Journal of health economics.

[41]  D. Deeg,et al.  Do early life and contemporaneous macroconditions explain health at older ages? , 2008 .

[42]  E. Crimmins,et al.  Does childhood health affect chronic morbidity in later life? , 2001, Social science & medicine.

[43]  M. Byrnes,et al.  Reconsidering Successful Aging , 2009 .

[44]  Richard G. Wilkinson,et al.  Income Inequality and Social Dysfunction , 2009 .

[45]  W. V. van Staveren,et al.  Dietary quality, lifestyle factors and healthy ageing in Europe: the SENECA study. , 2003, Age and ageing.

[46]  Annie Britton,et al.  Successful Aging: The Contribution of Early‐Life and Midlife Risk Factors , 2008, Journal of the American Geriatrics Society.

[47]  K. Christensen,et al.  Being Born Under Adverse Economic Conditions Leads to a Higher Cardiovascular Mortality Rate Later in Life: Evidence Based on Individuals Born at Different Stages of the Business Cycle , 2008, Demography.

[48]  O. Lundberg,et al.  Childhood living conditions, socioeconomic position in adulthood, and cognition in later life: exploring the associations. , 2009, The journals of gerontology. Series B, Psychological sciences and social sciences.

[49]  J. Banks,et al.  Childhood Health and Differences in Late-Life Health Outcomes between England and the United States , 2011 .

[50]  G. Carrin,et al.  Exploring the health impact of economic growth, poverty reduction and public health expenditure , 1996 .

[51]  Steven A. Haas Trajectories of functional health: the 'long arm' of childhood health and socioeconomic factors. , 2008, Social science & medicine.

[52]  Hendrik Jürges,et al.  True health vs response styles: exploring cross-country differences in self-reported health. , 2007, Health economics.

[53]  Rob Clark World health inequality: convergence, divergence, and development. , 2011, Social science & medicine.

[54]  R. Stewart,et al.  Ascertaining late‐life depressive symptoms in Europe: an evaluation of the survey version of the EURO‐D scale in 10 nations. The SHARE project , 2008, International journal of methods in psychiatric research.