Lifecourse socioeconomic circumstances and multimorbidity among older adults

BMC Public Health

Research Article

Reginald D Tucker-Seeley¹  Glorian Sorensen¹  Yi Li²  SV Subramanian³ 

[1] Center for Community Based Research, Dana-Farber Cancer Institute, 450 Brookline Ave, 02215, Boston, MA, USA;Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Ave, 02115, Boston, MA, USA;Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, 450 Brookline Ave, 02215, Boston, MA, USA;Department of Biostatistics, Harvard School of Public Health, 677 Huntington Ave, 02115, Boston, MA, USA;Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Ave, 02115, Boston, MA, USA;

关键词: Educational Attainment;    Chronic Condition;    Financial Hardship;    Multiple Chronic Condition;    Middle Adulthood;   

DOI  :  10.1186/1471-2458-11-313

 received in 2010-12-06, accepted in 2011-05-14,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMany older adults manage multiple chronic conditions (i.e. multimorbidity); and many of these chronic conditions share common risk factors such as low socioeconomic status (SES) in adulthood and low SES across the lifecourse. To better capture socioeconomic condition in childhood, recent research in lifecourse epidemiology has broadened the notion of SES to include the experience of specific hardships. In this study we investigate the association among childhood financial hardship, lifetime earnings, and multimorbidity.MethodsCross-sectional analysis of 7,305 participants age 50 and older from the 2004 Health and Retirement Study (HRS) who also gave permission for their HRS records to be linked to their Social Security Records in the United States. Zero-inflated Poisson regression models were used to simultaneously model the likelihood of the absence of morbidity and the expected number of chronic conditions.ResultsChildhood financial hardship and lifetime earnings were not associated with the absence of morbidity. However, childhood financial hardship was associated with an 8% higher number of chronic conditions; and, an increase in lifetime earnings, operationalized as average annual earnings during young and middle adulthood, was associated with a 5% lower number of chronic conditions reported. We also found a significant interaction between childhood financial hardship and lifetime earnings on multimorbidity.ConclusionsThis study shows that childhood financial hardship and lifetime earnings are associated with multimorbidity, but not associated with the absence of morbidity. Lifetime earnings modified the association between childhood financial hardship and multimorbidity suggesting that this association is differentially influential depending on earnings across young and middle adulthood. Further research is needed to elucidate lifecourse socioeconomic pathways associated with the absence of morbidity and the presence of multimorbidity among older adults.

【 授权许可】

CC BY   
© Tucker-Seeley et al; licensee BioMed Central Ltd. 2011