Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood

Abstract

A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes. Most of these studies, however, are based on middle-aged male populations and pay insufficient attention to the pathways between childhood risks and specific adult disorders. This article examines gender differences in the link between childhood SES and heart attack risk trajectories and the mechanisms by which early environments affect future disease risk. By using methods that model both latent and path-specific influences, we identify heterogeneity in early life conditions and human, social, and health capital in adulthood that contribute to diverse heart attack risk trajectories between and among men and women as they age into their 60s and 70s. We find that key risk factors for heart attack operate differently for men and women. For men, childhood SES does not differentiate those at low, increasing, and high risk for heart attack. In contrast, women who grew up without a father and/or under adverse economic conditions are the most likely to experience elevated risk for heart attack, even after we adjust for the unequal distribution of working and living conditions, social relationships, access to health care, and adult lifestyle behaviors that influence health outcomes.

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References

  1. Aboderin, I., A. Kalache, Y. Ben-Shlomo, J.W. Lynch, C.S. Yajnik, D. Kuh, and D. Yack. 2002. Life Course Perspectives on Coronary Heart Disease, Stroke and Diabetes: Key Issues and Implications for Policy and Research. Geneva: World Health Organization.

    Google Scholar 

  2. Allison, P.D. 2002. Missing Data. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  3. American Heart Association. 2005. Heart Disease and Stroke Statistics—2005 Update. Dallas, TX: American Heart Association.

    Google Scholar 

  4. Barker, D.J.P. 1992. Fetal and Infant Origins of Adult Disease. London: BMJ Publishing Group.

    Google Scholar 

  5. —. 1999. “Fetal Origins of Cardiovascular Disease.” Annals of Medicine 31:3–6.

    Google Scholar 

  6. Barker, D.J.P., T. Forsén, A. Uutela, C. Osmond, and J.G. Eriksson. 2001. “Size at Birth and Resilience to Effects of Poor Living Conditions in Adult Life: Longitudinal Study.” British Medical Journal 323:1–5.

    Article  Google Scholar 

  7. Barker, D.J.P. and P.D. Gluckman. 1993. “Fetal Nutrition and Cardiovascular Disease in Adult Life.” Lancet 341:938–41.

    Article  Google Scholar 

  8. Beebe-Dimmer, J., J.W. Lynch, G. Turrell, S. Lustgarten, T. Raghunathan, and G.A. Kaplan. 2004. “Childhood and Adult Socioeconomic Conditions and 31-Year Mortality in Women.” American Journal of Epidemiology 159:481–90.

    Article  Google Scholar 

  9. Ben-Shlomo, Y. and D. Kuh. 2002. “A Life Course Approach to Chronic Disease Epidemiology: Conceptual Models, Empirical Challenges and Interdisciplinary Perspectives.” International Journal of Epidemiology 31:285–93.

    Article  Google Scholar 

  10. Blane, D., C.L. Hard, D.G. Smith, C.R. Gillis, D.J. Hole, and V.M. Hawthorne. 1996. “Association of Cardiovascular Disease Risk Factors With Socioeconomic Position During Childhood and During Adulthood.” British Medical Journal 313:1434–38.

    Google Scholar 

  11. Blackwell, D.L., M. Hayward, and E. Crimmins. 2001. “Does Childhood Health Affect Chronic Morbidity in Later Life?” Social Science & Medicine 52:1269–84.

    Article  Google Scholar 

  12. Bouwmeester, S., K. Sijtsma, and J.K. Vermunt. 2004. “Latent Class Regression Analysis for Describing Cognitive Developmental Phenomena: An Application to Transitive Reasoning.” European Journal of Developmental Psychology 1:67–86.

    Article  Google Scholar 

  13. Chandola, T., H. Kuper, A. Singh-Manoux, M. Bartley, and M. Marmot. 2004. “The Effect of Control at Home on CHD Events in the Whitehall II Study: Gender Differences in Psychosocial Domestic Pathways to Social Inequalities in CHD.” Social Science and Medicine 58:1501–09.

    Article  Google Scholar 

  14. Clausen, B., G.D. Smith, and D. Thelle. 2003. “Impact of Childhood and Adulthood Socioeconomic Position on Cause Specific Mortality: The Oslo Mortality Study.” Journal of Epidemiology and Community Health 57:40–45.

    Article  Google Scholar 

  15. Coltrane, S. 2000. “Research on Household Labor: Modeling and Measuring the Social Embeddedness of Routine Family Work.” Journal of Marriage and the Family 62:1208–33.

    Article  Google Scholar 

  16. Crawford, P.B., E. Obarzanke, G.B. Schreiber, P. Barrier, S. Goldman, M.M. Frederick, and Z.I. Sabry. 1995. “The Effects of Race, Household Income, and Parental Education on Nutrient Intakes of 9- and 10-Year-Old Girls.” Annals of Epidemiology 5:360–68.

    Article  Google Scholar 

  17. Cruz-Medina, I.R., T.P. Hettmansperger, and H. Thomas. 2004. “Semiparametric Mixture Models and Repeated Measures: The Multinomial Cut Point Model.” Applied Statistics 43:463–74.

    Google Scholar 

  18. Denton, M., S. Prus, and V. Walters. 2004. “Gender Differences in Health: A Canadian Study of the Psychosocial, Structural, and Behavioral Determinants of Health.” Social Science and Medicine 58:2585–600.

    Article  Google Scholar 

  19. de Vries, B. and D. Watt. 1996. “A Lifetime of Events: Age and Gender Variations in the Life Story.” International Journal of Aging and Human Development 42:81–102.

    Article  Google Scholar 

  20. Dixon, J.P., J.K. Dixon, and J.C. Spinner. 1991. “Tensions Between Career and Interpersonal Communications as a Risk Factor for Cardiovascular Disease Among Women.” Women and Health 17:33–57.

    Article  Google Scholar 

  21. Dong, W., Y. Ben-Shlomo, H. Colhoun, and N. Chaturvedi. 1998. “Gender Differences in Accessing Cardiac Surgery Across England: A Cross-Sectional Analysis of the Health Survey for England.” Social Science and Medicine 47:1773–80.

    Article  Google Scholar 

  22. Frone, M.R., M. Russell, and M.L. Cooper. 1997. “Relation of Work-Family Conflict to Health Outcomes: A Four-Year Longitudinal Study of Employed Parents.” Journal of Occupational and Organizational Psychology 70:325–35.

    Google Scholar 

  23. Galobardes, B., J.W. Lynch, and G. Davey Smith. 2004. “Childhood Socioeconomic Circumstances and Cause-Speci c Mortality in Adulthood: Systematic Review and Interpretation.” Epidemiologic Reviews 26:7–21.

    Article  Google Scholar 

  24. Graham, M.J., U. Larsen, and X. Xu. 1998. “Son Preference in Anhui Province, China.” International Family Planning Perspectives 24:72–77.

    Article  Google Scholar 

  25. Halfon, N. and M. Hochstein. 2002. “Life Course Health Development: An Integrated Framework for Developing Health, Policy and Research.” Milbank Quarterly 80:433–80.

    Article  Google Scholar 

  26. Hayward, M.D. and B.K. Gorman. 2004. “The Long Arm of Childhood: The Influence of Early-Life Social Conditions on Men’s Mortality.” Demography 41:87–107.

    Article  Google Scholar 

  27. Hertzman, C. 1999. “The Biological Embedding of Early Experience and Its Effects on Health in Adulthood.” Annals of the New York Academy of Sciences 896:85–95.

    Article  Google Scholar 

  28. House, J. 2002. “Understanding Social Factors and Inequalities in Health: 20th Century Progress and 21st Century Prospects.” Journal of Health and Social Behavior 43:125–42.

    Article  Google Scholar 

  29. Jensen, R. 2003. “Studies on the Status, Rights and Well-being of Women in the Developing World.” Working paper. Women and Public Policy Program, Harvard University.

  30. Johnson, R.K., D.G. Johnson, M.Q. Wang, H. Smiciklas-Wright, and H.A. Guthrie. 1994. “Characterizing Nutrient Intakes of Adolescents by Sociodemographic Factors.” Journal of Adolescent Health 15:149–54.

    Article  Google Scholar 

  31. Joint European Society of Cardiology/American College of Cardiology Committee. 2000. “Myocardial Infarction Rede ned: A Consensus Document of the Joint European Society of Cardiology/ American College of Cardiology Committee for the Redefinition of Myocardial Infarction.” Journal of the American College of Cardiology 36:959–69.

    Article  Google Scholar 

  32. Krieger, N. 1998. “Adult Female Twins’ Recall of Childhood Social Class and Father’s Education: A Validation Study for Public Health Research.” American Journal of Epidemiology 147: 704–708.

    Google Scholar 

  33. Kuh, D., R. Hardy, C. Langenberg, M. Richards, and M.E.J. Wadsworth. 2002. “Mortality in Adults Aged 26-54 Years Related to Socioeconomic Conditions in Childhood and Adulthood: Post War Birth Cohort Study.” British Medical Journal 325:1076–80.

    Article  Google Scholar 

  34. Lawlor, D.A., G.D. Smith, and S. Ebrahim. 2004. “Association Between Childhood Socioeconomic Status and Coronary Heart Disease Risk Among Postmenopausal Women: Findings From the British Women’s Heart and Health Study.” American Journal of Public Health 94:1386–92.

    Article  Google Scholar 

  35. Li, S., W. Chen, S.R. Srinivasan, M.G. Bond, R. Tang, E.M. Urbina, and G.S. Berenson. 2003. “Childhood Cardiovascular Risk Factors and Carotid Vascular Changes in Adulthood.” Journal of the American Medical Association 290:2271–76.

    Article  Google Scholar 

  36. Lundberg, U. 1996. “The Influence of Paid and Unpaid Work on Psychophysiological Stress Responses of Men and Women.” Journal of Occupational Health Psychology 1:117–30.

    Article  Google Scholar 

  37. Lundberg, U. and D. Parr. 2000. “Neurohormonal Factors, Stress, Health, and Gender.” Pp. 21–42 in Handbook of Gender, Culture and Health, edited by R.M. Eisler and M. Hersen. Mahwah, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  38. Luo, Y. and L.J. Waite. 2005. “The Impact of Childhood and Adult SES on Physical, Mental, and Cognitive Well-being in Later Life.” Journal of Gerontology: Social Sciences 60:93–101.

    Google Scholar 

  39. Marmot, M.G., H. Bosma, H. Hemingway, E. Brunner, and S. Stansfeld. 1997. “Contribution of Job Control and Other Risk Factors to Social Variations in Coronary Heart Disease Incidence.” Lancet 350:235–39.

    Article  Google Scholar 

  40. Martin, R.M., A.R. Ness, D. Gunnell, P. Emmett, and G.D. Smith. 2004. “Does Breast-Feeding in Infancy Lower Blood Pressure in Childhood?” Circulation 109:1259–66.

    Article  Google Scholar 

  41. Martyn C.N., D.J. Barker, and C. Osmond. 1996. “Mother’s Pelvic Size, Fetal Growth, and Death From Stroke and Coronary Heart Disease in Men in the UK.” The Lancet 348:1264–68.

    Article  Google Scholar 

  42. McEwen, B.S. and T. Seeman. 1999. “Protective and Damaging Effects of Mediators of Stress: Elaborating and Testing the Concepts of Allostasis and Allostatic Load.” Annals of the New York Academy of Sciences 896:30–47.

    Article  Google Scholar 

  43. McKinlay, J.B. 1996. “Some Contributions From the Social System to Gender Inequalities in Heart Disease.” Journal of Health and Social Behavior 37:1–26.

    Article  Google Scholar 

  44. Miura, K., H. Nakagawa, M. Tabata, Y. Morikawa, M. Nishijo, and S. Kagamimori. 2001. “Birth Weight, Childhood Growth, and Cardiovascular Disease Risk Factors in Japanese Aged 20 Years.” American Journal of Epidemiology 153:783–89.

    Article  Google Scholar 

  45. Montgomery, S.M., L.R. Berney, and D. Blane. 2000. “Prepubertal Stature and Blood Pressure in Early Old Age.” Archives of Disease in Childhood 82:358–63.

    Article  Google Scholar 

  46. Moore, V.M. and M.J. Davies. 2005. “Diet During Pregnancy, Neonatal Outcomes and Later Health.” Reproduction, Fertility and Development 17:341–48.

    Article  Google Scholar 

  47. Moura, A.S., F.G. Pereira, and C.A. Mandarim-de-Lacerda. 2004. “Gender Determines Long- Lasting Effects on Adult Offspring Heart After Early-Life Malnourishment.” Biology of the Neonate 85:256–62.

    Article  Google Scholar 

  48. Muller, J.E., G.S. Abela, R.W. Nestro, and G.H. To er. 1994. “Triggers, Acute Risk Factors and Vulnerable Plaques: The Lexicon of a New Frontier.” Journal of the American College of Cardiology 23:809–13.

    Article  Google Scholar 

  49. Newby, L.K., J.S. Alpert, E.M. Ohman, K. Thygesen, and R.M. Califf. 2002. “Changing the Diagnosis of Acute Myocardial Infarction: Implications for Practice and Clinical Investigation.” American Heart Journal 144:957–80.

    Article  Google Scholar 

  50. Naess, O., B. Claussen, D.S. Thelle, and G. Davey Smith. 2004. “Cumulative Deprivation and Cause Specific Mortality: A Census Based Study of Life Course Influences Over Three Decades.” Journal of Epidemiology and Community Health 58:599–603.

    Article  Google Scholar 

  51. Norgan, N.G. 2000. “Long-Term Physiological and Economic Consequences of Growth Retardation in Children and Adolescents.” Proceedings of the Nutrition Society 59:245–56.

    Google Scholar 

  52. Norris, R.M. 2000. “Coronary Disease: The Natural History of Acute Myocardial Infarction.” Heart 83:726–30.

    Article  Google Scholar 

  53. O’Rand, A.M. and J. Hamil-Luker. 2005. “Processes of Cumulative Adversity Linking Childhood Disadvantage to Increased Risk of Heart Attack.” Journal of Gerontology: Social Sciences 60B(Special Issue II):117–24.

    Google Scholar 

  54. Pensola, T.H. and P. Martikainen. 2003. “Cumulative Social Class and Mortality From Various Causes of Adult Men.” Journal of Epidemiology and Community Health 57:745–51.

    Article  Google Scholar 

  55. Pfeffer, M.A. and J.J.V. McMurray. 2002. “Myocardial Infarct: No One Size Fits All.” Circulation 105:2577–79.

    Article  Google Scholar 

  56. Power, C. and C. Hertzman. 1997. “Social and Biological Pathways Linking Early Life and Adult Disease.” British Medical Bulletin 53:210–21.

    Google Scholar 

  57. Rahkonen, O., E. Lahelma, and M. Huuhka. 1997. “Past or Present? Childhood Living Conditions and Current Socioeconomic Status as Determinants of Adult Health.” Social Science & Medicine 44:327–36.

    Article  Google Scholar 

  58. Rich-Edwards, J.W., M.J. Stampfer, J.E. Manson, B. Rosner, S.E. Hankinson, G.A. Colditz, W.C. Willett, and C.H. Hennekens. 1997. “Birth Weight and Risk of Cardiovascular Disease in a Cohort of Women Followed Up Since 1976.” British Medical Journal 315:396–400.

    Google Scholar 

  59. Rich-Edwards, J.W., M.J. Stampfer, J.E. Manson, B. Rosner, F.B. Hu, K.B. Michels, and W.C. Willett. 2004. “Breastfeeding During Infancy and the Risk of Cardiovascular Disease in Adulthood.” Epidemiology 15:550–56.

    Article  Google Scholar 

  60. Roberts, B.H. 2004. “Gender-Speci c Aspects of the Experience of Coronary Artery Disease.” Pp. 215–23 in Principles of Gender-Specific Medicine, edited by M.J. Legato. Boston: Elsevier Academic Press.

    Google Scholar 

  61. Ross, C.E. and C.E. Bird. 1994. “Sex Stratification and Health Lifestyle: Consequences for Men’s and Women’s Perceived Health.” Journal of Health and Social Behavior 35:161–78.

    Article  Google Scholar 

  62. Ross, M.T., D.V. Grafham, A.J. Coffey, S. Scherer, et al. 2005. “The DNA Sequence of the Human X Chromosome.” Nature 434:325–37.

    Article  Google Scholar 

  63. Rubin, D.B. 1987. Multiple Imputation for Nonresponse in Surveys. New York: John Wiley.

    Book  Google Scholar 

  64. Schoenberg, N., J.C. Peters, and E.M. Drew. 2003. “Unraveling the Mysteries of Timing: Women’s Perceptions About Time to Treatment for Cardiac Symptoms.” Social Science & Medicine 56:271–84.

    Article  Google Scholar 

  65. Singh-Manoux, A., J.E. Ferrie, T. Chandola, and M. Marmot. 2004. “Socioeconomic Trajectories Across the Life Course and Health Outcomes in Midlife.” International Journal of Epidemiology 33:1072–79.

    Article  Google Scholar 

  66. Smith, G.D., C. Hart, M. Upton, D. Hole, C. Gillis, G. Watt, and V. Hawthorne. 2000. “Height and Risk of Death Among Men and Women: Aetiological Implications of Associations With Cardiorespiratory Disease and Cancer Mortality.” Journal of Epidemiology and Community Health 54:97–103.

    Article  Google Scholar 

  67. Steptoe, A. and M. Marmot. 2002. “The Role of Psychobiological Pathways in Socio-Economic Inequalities in Cardiovascular Disease Risk.” European Heart Journal 23:13–25.

    Article  Google Scholar 

  68. Turner, R.J. and W.R. Avison. 2003. “Status Variations in Stress Exposure: Implications for the Interpretation of Research on Race, Socioeconomic Status, and Gender.” Journal of Health and Social Behavior 44:488–505.

    Article  Google Scholar 

  69. Turner, R.J., B. Wheaton, and D.A. Lloyd. 1995. “The Epidemiology of Social Stress.” American Sociological Review 60:104–25.

    Article  Google Scholar 

  70. Vaccarino, V. and S. Mallik. 2004. “Gender Differences in the Outcome of Acute Myocardial Infarction.” Pp. 224–33 in Principles of Gender-Specific Medicine, edited by M.J. Legato. Boston: Elsevier Academic Press.

    Google Scholar 

  71. Vermunt, J.K. 2003. “Multilevel Latent Class Models.” Sociological Methodology 33:213–39.

    Article  Google Scholar 

  72. Vermunt, J.K. and J. Magidson. 2004. “Non-Parametric Random-Effects Model.” Pp. 732–33 in Encyclopedia of Social Science Research Methods, edited by M. Lewis-Beck, A.E. Bryman, and T.F. Liao. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  73. — 2004. “Hierarchical Mixture Models for Nested Data Structures.” Pp. 176–83 in Classification: The Ubiquitous Challenge, edited by C. Weihs and W. Gaul. Heidelberg: Springer.

    Google Scholar 

  74. Vermunt, J.K. and L. Van Dijk. 2001. “A Non-Parametric Random Coefficient Approach: The Latent Class Regression Model.” Multilevel Modeling Newsletter 13:6–13.

    Google Scholar 

  75. Wayem, J.A. 1997. The Gambia National Human Development Report. New York: United Nations Development Program.

    Google Scholar 

  76. Wedel, M. and W. DeSarbo. 1994. “A Review of Recent Developments in Latent Class Regression Models.” Pp. 352–88 in Advanced Methods of Marketing Research, edited by R.P. Bagozzi. Cambridge, MA: Blackwell Publishers.

    Google Scholar 

  77. White, H.D. 2002. “Things Ain’t What They Used to Be: Impact of a New Definition of Myocardial Infarction.” American Heart Journal 144:933–37.

    Article  Google Scholar 

  78. Williams, K. and D. Umberson. 2004. “Marital Status, Marital Transitions and Health: A Gendered Life Course Perspective.” Journal of Health and Social Behavior 45:81–98.

    Article  Google Scholar 

  79. Wister, A.V. and E.M. Gee. 1994. “Age at Death Due to Ischemic Heart Disease: Gender Differences.” Social Biology 41:111–26.

    Google Scholar 

  80. Wizemann, T.M. and M.L. Pardue. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter? Washington, DC: National Academy Press.

    Google Scholar 

  81. Wu, G., F.W. Bazer, T.A. Cudd, C.J. Meininger, and T.E. Spencer. 2004. “Maternal Nutrition and Fetal Development.” Journal of Nutrition 134:2169–72.

    Google Scholar 

  82. Xie, B., F.D. Gilliland, L. Yu-Fen, and H. Rockett. 2003. “Effects of Ethnicity, Family Income, and Education on Dietary Intake Among Adolescents.” Preventive Medicine 36:30–40.

    Article  Google Scholar 

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Correspondence to Jenifer Hamil-Luker.

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Support for Dr. Hamil-Luker’s time was provided by NIA Grant AG00029.

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Hamil-Luker, J., O’rand, A.M. Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood. Demography 44, 137–158 (2007). https://doi.org/10.1353/dem.2007.0004

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Keywords

  • Heart Attack
  • Health Capital
  • Early Life Exposure
  • Health Trajectory
  • Childhood Circumstance