Growing Up in Poverty, Growing Old in Infirmity: The Long Arm of Childhood Conditions in Great Britain

Abstract

Background: The ageing population poses a tremendous challenge in understanding the sources of inequalities in health. Though they appear to be far removed, childhood conditions are known to be inextricably linked with adult health, and in turn on health in later life. The long arm of childhood conditions hypothesis is often tested using recollection of childhood circumstances, but such subjective recall can yield potentially inaccurate or possibly biased inferences. We tested the long arm hypothesis on three outcomes in later life, arrayed from objective to subjective health, namely: gait speed, episodic memory and mental health.

Methods and findings: We used the English Longitudinal Study of Ageing 2006 enriched with retrospective life history (N = 5,913). To deal with recall problems two solutions, covariate measurement and endogenous treatment models, were applied. Retrospective childhood material lack includes growing up without running hot or cold water, fixed bath, indoor lavatory and central heating. Adjustment is made for an extensive set of confounders including sex, age, adult health, wealth, education, occupation, social support, social connections, chronic conditions, smoking, drinking, and physical exercise. It is found that material poverty when growing up shows no association with health when growing old, assuming accurate recall. Once recall problems are controlled, we found that childhood material poverty changes inversely with later life health.

Conclusion: A poorer childhood goes with slower gait, poorer memory and more depression in later life. This result provides a further impetus to eliminate child poverty.

Fig 1. Childhood conditions and health in later life: gait speed (fully adjusted models).

Source: The English Longitudinal Study of Ageing 2006.

Fig 2. Childhood conditions and health in later life: Episodic memory (fully adjusted models).

Source: The English Longitudinal Study of Ageing 2006.

Fig 3. Childhood conditions and health in later life: Mental health (fully adjusted models).

Source: The English Longitudinal Study of Ageing 2006.

Fig 4. Childhood conditions (standardised estimates) and health in later life: gait speed, episodic memory and mental health (fully adjusted models).

Source: The English Longitudinal Study of Ageing 2006.