Direct and indirect effects of childhood conditions on survival and health among male and female elderly in China

• Published in: Social science & medicine (1982) Vol. 119; pp. 207 - 214
• Main Authors: Shen, Ke, Zeng, Yi
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2014; Pergamon Press Inc
• Subjects: Age Distribution; Aged; Aged, 80 and over; Childhood; Childhood conditions; China; China - epidemiology; Demography; Elderly; Female; Health; Health Behavior; Health Problems; Health Status; Health Status Disparities; Health Surveys; Humans; Longevity; Longitudinal Studies; Male; Mathematical models; Mortality; Mortality Rates; Older people; Peoples Republic of China; Public health; Sex Distribution; Socioeconomic Factors; Socioeconomic Status; Structural analysis; Structural equation model; Survival analysis; Well Being; China; Childhood conditions; Socioeconomic status; Health; China; Structural equation model
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2014.07.003

This paper investigates whether childhood conditions affect survival and health, both directly and indirectly through the mediating variable of adulthood socioeconomic status, among Chinese elderly. Using data from the 2008–2009 and 2011–2012 waves of the Chinese Longitudinal Healthy Longevity Survey, we apply structural equation models to estimate these effects. We find that favorable childhood conditions exert a negative direct impact on survival probability at senior ages, possibly resulting from mortality selection. Our results also support the pathways model, which indicates that advantageous childhood conditions improve socioeconomic status in adulthood and thus indirectly promote longevity and health at advanced ages. Combining the direct and indirect effects, the total effects of childhood advantages on survival and health are positive. We further demonstrate that direct and indirect effects of childhood conditions are stronger for women than they are for men. Our findings suggest that public policies that target childhood wellbeing may have far-reaching protective impacts on health among seniors. •Childhood adversities directly increase survival at old ages possibly through selection.•Favorable childhood conditions indirectly improve survival and health at old ages.•Direct and indirect effects of childhood conditions are stronger for women than for men.