Early-life conditions and health at older ages: The mediating role of educational attainment, family and employment trajectories

ObjectivesWe examine to what extent the effect of early-life conditions (health and socioeconomic status) on health in later life is mediated by educational attainment and life-course trajectories (fertility, partnership, employment).MethodsUsing data from the Survey of Health, Ageing and Retirement in Europe (N = 12,034), we apply, separately by gender, multichannel sequence analysis and cluster analysis to obtain groups of similar family and employment histories. The KHB method is used to disentangle direct and indirect effects of early-life conditions on health.ResultsEarly-life-conditions indirectly impact on health in later life as result of their influence on education and family and employment trajectories. For example, between 22% and 42% of the effect of low parental socio-economic status at childhood on the three considered health outcomes at older age is explained by educational attainment for women. Even higher percentages are found for men (35% - 57%). On the contrary, the positive effect of poor health at childhood on poor health at older ages is not significantly mediated by education and life-course trajectories. Education captures most of the mediating effect of parental socio-economic status. More specifically, between 66% and 75% of the indirect effect of low parental socio-economic status at childhood on the three considered health outcomes at older age is explained by educational attainment for women. Again, higher percentages are found for men (86% - 93%). Early-life conditions, especially socioeconomic status, influence family and employment trajectories indirectly through their impact on education. We also find a persistent direct impact of early-life conditions on health at older ages.ConclusionsOur findings demonstrate that early-life experiences influence education and life-course trajectories and health in later life, suggesting that public investments in children are expected to produce long lasting effects on people’s lives throughout the different phases of their life-course.

研究目标
本研究旨在探讨早期生活条件（健康与社会经济地位）对老年健康的影响，在多大程度上通过受教育程度与生命历程轨迹（生育、伴侣关系、就业）实现中介传导。

研究方法
本研究采用欧洲健康、老龄化与退休调查（Survey of Health, Ageing and Retirement in Europe）的数据（样本量N=12034），分别按性别开展多通道序列分析与聚类分析，以获取具有相似家庭与就业经历的群体。同时采用KHB方法拆解早期生活条件对健康的直接效应与间接效应。

研究结果
早期生活条件通过影响受教育程度、家庭与就业轨迹，间接作用于老年健康。例如，对于女性而言，童年时期父母社会经济地位较低对其3项既定老年健康结局的影响中，有22%至42%可通过受教育程度得到解释；男性的这一中介占比更高，达35%至57%。与之相反，童年时期健康状况不佳对老年健康不良的正向影响，并未通过受教育程度与生命历程轨迹得到显著中介。
受教育程度在父母社会经济地位的中介效应中贡献最大：具体而言，女性童年时期父母社会经济地位较低对其3项老年健康结局的间接效应中，有66%至75%可由受教育程度单独解释；男性的对应占比更高（86%至93%）。早期生活条件，尤其是社会经济地位，通过影响受教育程度间接作用于家庭与就业轨迹。本研究同时发现，早期生活条件对老年健康仍存在持续的直接效应。

研究结论
本研究结果表明，早期生活经历通过影响受教育程度与生命历程轨迹，进而作用于老年健康，这提示对儿童的公共投资有望在个体整个生命历程的不同阶段，对其生活产生长期持久的影响。