Parental socioeconomic position, childhood poverty and healthy ageing: retrospective and prospective study of six cohorts across 32 wealthy and developing nations

Background and Aim: The childhood poor in wealthy countries have reported worse cognitive, muscle and mental functions as well as more frailty and multimorbidity as older adults. But it is uncertain whether the childhood poor around the world fall short of attaining healthy ageing because information of childhood conditions is often erroneous. Here I present new evidence on the life course shaping of healthy ageing among older adults around the world.

Methods: Some 80 thousand older adults over 50 years in 32 wealthy and developing nations recalled their childhood conditions at ten to fourteen, then prospectively reported their health functionings. By the decade's end these countries host more than half (53%) of the world population of 60 year and over according to the United Nations. Following recent empirical studies, a modified healthy ageing scale is constructed using a generalised latent trait model. The childhood conditions in England, Ireland and continental Europe include numbers of books, rooms and people (indicating overcrowding), presence of running hot water and central heating. Across in America, these are mostly replaced with financial hardship or family indebtedness; in China starvation to death due to government edict while in Indonesia presence of running cold water. Per prior practice childhood poverty is a latent construct of these error-laced recollections. Its associations with healthy ageing scale (modified) are obtained with fixed effects model, controlling for parental socioeconomic position, age, sex, education, wealth and marital status. Extensive sensitivity analyses assessed robustness.

Results and Discussion: Childhood poverty is associated with reduced healthy ageing by 0.14 standard deviation (z = -17.6); older adults who grew up poor have lower healthy ageing scores relative to those who were not poor. And women reported lower healthy ageing scores. Distributions of healthy ageing vary across countries, as do age profiles of healthy ageing in older adults. Childhood poverty is common in developing countries and non-negligible in rich countries. Social and economic progress over the long peaceful century is no guarantee of a complete poverty eradication promised by the world leaders in the UN 2030 Agenda for Sustainable Development. In fact, lifting all children out of poverty is set to face more challenges with regional wars in across the world. Childhood recollections show that the childhood poor grow old falling short of healthy ageing, making the life course shaping of healthy ageing central. And the strong evidence presented here calls for urgent actions to eliminate child poverty on account of its lifelong rewards. Researchers can now use childhood recollections across wealthy and developing nations alike, despite their measurement errors and their variation in elicitation, to estimate their associations with older adults' health. And health policy makers should adopt a life course approach when evaluating childhood health interventions on account of their lifelong associations.