Early-life social origins of later-life body weight: The role of socioeconomic status and health behaviors over the life course
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
References (78)
- et al.
Obesity and physical activity: a review
Am. Heart J.
(2006) - et al.
Role of depressive symptoms in explaining socioeconomic status disparities in dietary quality and central adiposity among US adults: a structural equation modeling approach
Am. J. Clin. Nutr.
(2009) - et al.
Obesity and cortisol
Nutrition
(2000) - et al.
Lifetime income patterns and alcohol consumption: investigating the association between long- and short-term income trajectories and drinking
Soc. Sci. Med.
(2011) - et al.
Education inequality in mortality: the age and gender specific mediating effects of cigarette smoking
Soc. Sci. Res.
(2010) - et al.
Long-term low-protein, low-calorie diet and endurance exercise modulate metabolic factors associated with cancer risk
Am. J. Clin. Nutr.
(2006) - et al.
Socioeconomic disadvantage in adolescent women and metabolic syndrome in mid-adulthood: an examination of pathways of embodiment in the Northern Swedish Cohort
Soc. Sci. Med.
(2012) - et al.
Sports participation and physical education in American secondary schools: current levels and racial/ethnic and socioeconomic disparities
Am. J. Prev. Med.
(2007) - et al.
What is a cohort effect? Comparison of three statistical methods for modeling cohort effects in obesity prevalence in the United States, 1971–2006
Soc. Sci. Med.
(2010) - et al.
Social origins, early hardship and obesity: a strong association in women, but not in men?
Soc. Sci. Med.
(2009)
Effects of alcohol intake on resting energy expenditure in young women social drinkers
Am. J. Clin. Nutr.
Social and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults
Soc. Sci. Med.
Life course models of socioeconomic position and cardiovascular risk factors: 1946 birth cohort
Ann. Epidemiol.
Gender, health behavior, and intimate relationships: lesbian, gay, and straight contexts
Soc. Sci. Med.
Measuring health disparities: trends in racial-ethnic and socioeconomic disparities in obesity among 2- to 18-year old youth in the United States, 2001–2010
Ann. Epidemiol.
Parenthood and trajectories of change in body weight over the life course
Soc. Sci. Med.
Population heterogeneity in the impact of body weight on mortality
Soc. Sci. Med.
Race/ethnicity, life-course socioeconomic position, and body weight trajectories over 34 years: the Alameda County Study
Am. J. Public Health
A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives
Int. J. Epidemiol.
Association of cardiovascular disease risk factors with socioeconomic position during childhood and during adulthood
Br. Med. J.
When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood
J. Epidemiol. Community Health
“My daughter has a career; I just raised babies”: the psychological consequences of women’s intergenerational social comparisons
Social Psychology Quarterly
Childhood IQ in relation to obesity and weight gain in adult life: the National Child Development (1958) Study
Int. J. Obes.
Neighborhood racial isolation, disorder and obesity
Soc. Forces
Social disparities in BMI trajectories across adulthood by gender, race/ethnicity and lifetime socio-economic position: 1986–2004
Int. J. Epidemiol.
Dietary and lifestyle correlates of plasma insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3): the multiethnic cohort
Cancer Epidemiol. Biomark. Prev.
Health consequences of obesity in youth: childhood predictors of adult disease
Pediatrics
Cumulative advantage as a mechanism for inequality: a review of theoretical and empirical developments
Ann. Rev. Sociol.
Obesity, diets, and social inequalities
Nutr. Rev.
Physical activity, aerobic fitness, and seven-year changes in adiposity in the Canadian population
Can. J. Appl. Physiol.
Abdominal visceral and subcutaneous adipose tissue compartments association with metabolic risk factors in the Framingham heart study
Circulation
The skinny on success: body mass, gender and occupational standing across the life course
Soc. Forces
Socioeconomic position at different stages of the life course and its influence on body weight and weight gain in adulthood: a longitudinal study with 13-year follow-up
Obesity
Physical activity and weight management across the lifespan
Annu. Rev. Public Health
Inequality in the built environment underlies key health disparities in physical activity and obesity
Pediatrics
Physical activity and inactivity in an adult population assessed by accelerometry
Med. Sci. Sports Exerc.
Disparities in data on Healthy People 2010 physical activity objectives collected by accelerometry and self-report
Am. J. Public Health
Explaining the effect of gender on functional transitions in older persons
Gerontology
Social mobility and social accumulation across the life course in relation to adult overweight and obesity: the Whitehall II study
J. Epidemiol. Community Health
Cited by (0)
- 1
Equal contribution.