Elsevier

Social Science Research

Volume 46, July 2014, Pages 59-71
Social Science Research

Early-life social origins of later-life body weight: The role of socioeconomic status and health behaviors over the life course

https://doi.org/10.1016/j.ssresearch.2014.02.007Get rights and content

Highlights

  • SES in adolescence is related negatively to body weight in midlife and later life.

  • Early socioeconomic disadvantage has a stronger effect on women’s than men’s weight.

  • Life-course health behaviors and SES partly mediate the effect of early-life SES.

  • The direct effect of socioeconomic background persists net of all mediators.

  • Policies addressing obesity in mid- and late life should adopt a life course approach.

Abstract

Using the 1957–2004 data from the Wisconsin Longitudinal Study, we apply structural equation modeling to examine gender-specific effects of family socioeconomic status (SES) at age 18 on body weight at age 65. We further explore SES and health behaviors over the life course as mechanisms linking family background and later-life body weight. We find that early-life socioeconomic disadvantage is related to higher body weight at age 65 and a steeper weight increase between midlife and late life. These adverse effects are stronger among women than men. Significant mediators of the effect of parents’ SES include adolescent body mass (especially among women) as well as exercise and SES in midlife. Yet, consistent with the critical period mechanism, the effect of early-life SES on late-life body weight persists net of all mediating variables. This study expands current understanding of life-course mechanisms that contribute to obesity and increase biological vulnerability to social disadvantage.

Introduction

Research consistently documents the enduring consequences of social environment in childhood and adolescence for life-course trajectories of body weight (Baltrus et al., 2005, James et al., 2006, Langenberg et al., 2003). Socioeconomic status (SES) of the family of origin is a particularly important influence, with children from disadvantaged socioeconomic backgrounds having higher body mass index (BMI) and a greater risk of overweight and obesity in adulthood than children from higher-SES families (Giskes et al., 2008, Khlat et al., 2009, Parsons et al., 1999). Although the long-term effects of early-life socioeconomic resources on body weight in adulthood have been studied extensively, previous research is limited in several important ways. Most longitudinal studies are characterized by a relatively short follow-up, with participants being followed only into young adulthood (Chandola et al., 2006, Parsons et al., 1999) and, rarely, into midlife (Langenberg et al., 2003). Therefore, it is not known whether the reach of early-life SES extends to body weight in later life. When studies do focus on middle-aged and older adults, participants are typically not recruited in childhood but entered the study at midlife, which can obscure differential survival by SES and obesity. Further, in most studies, parents’ SES is assessed with one measure, mostly the father’s occupation, which does not fully capture the multidimensional nature of socioeconomic environment and does not incorporate measurement error (Baltrus et al., 2005, Langenberg et al., 2003). Another methodological limitation is an overwhelming reliance on retrospective reports of early-life SES that may be subject to recall bias and lead to underestimation of the true effect (Giskes et al., 2008, James et al., 2006). Moreover, few studies have explicitly examined gender differences in the life-course mechanisms conveying the effect of early-life SES on body weight in adulthood and later life.

We use the 1957–2004 data from 5778 participants in the Wisconsin Longitudinal Study to examine how family SES at age 18 (in 1957) affects men’s and women’s body mass index (BMI) in 2004 at age 65. We explore SES and health behaviors over the life course as mechanisms linking socioeconomic family background and later-life body weight. Using structural equation modeling, we decompose the effect of early-life SES into direct and indirect (mediated) effects and compare the relative importance of each hypothesized mechanism in conveying the effect of parents’ SES on offspring’s BMI in later life. Moreover, we use multiple-group analysis to explore gender differences in the effect of early-life SES and life-course mechanisms underlying this effect. Another methodological contribution of our study is modeling SES at each life-course stage as a latent variable to incorporate multiple indicators and measurement error. Finally, the prospective longitudinal nature of the WLS allows us to address the issues of recall bias and selection bias.

Section snippets

Background

Body weight is a multi-faceted phenomenon with a contested cultural meaning and complex biosocial antecedents and consequences. The medical and public health discourse emphasizes individual-level health risks and society-wide costs of overweight and obesity (Roos et al., 2012). Yet, the findings on the health consequences of heavier body weight are equivocal and complicated. Zheng and Yang (2012) show pronounced population heterogeneity in the effect of overweight and obesity on mortality

Analytic sample

The Wisconsin Longitudinal Study (WLS) is a long-term cohort study of 10,317 White men and women who graduated from Wisconsin high schools in 1957. Participants were interviewed at ages 17–18 (in 1957), 36 (in 1975), 53–54 (in 1993), and 64–65 (in 2004). This study’s analytic sample contains 2615 men and 3163 women who participated in the 1957 baseline survey and in the 1993 and 2004 interviews.

Results

The measurement part of the structural equation model is shown in Table 1. Standardized factor loadings and fit indices suggest that the indicators measure each factor well.

Discussion

This study documents an enduring effect of socioeconomic family background on body weight in midlife and later life among men and women. Our central finding that lower SES in adolescence is related to higher BMI decades later contributes to a growing body of evidence documenting the long reach of childhood socioeconomic environment (Gustafsson and Hammarström, 2012, James et al., 2006, Langenberg et al., 2003). It is important to emphasize that unequal trajectories of high- and low-SES

Conclusion

This study elucidates the importance of long-term consequences of early-life SES as a fundamental cause operating across the life course. We expand existing research by incorporating an array of prospective measures of early-life SES, assessing the dynamics of SES, health behaviors and BMI across the life course, and estimating the direct and indirect effects of SES in adolescence on BMI in later life through multiple mediating pathways. Our findings emphasize the complexity of life-course

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