Centre for Longitudinal Studies, University College London Social Research Institute, London, Greater London, UK
Centre for Longitudinal Studies, University College London Social Research Institute, London, Greater London, UK.
BMJ Open. 2020 Feb 20;10(2):e031416. doi: 10.1136/bmjopen-2019-031416.
We aim to examine the relative contributions of pathways from middle childhood/adolescence to mid-life well-being, health and cognition, in the context of family socio-economic status (SES) at birth, educational achievement and early-adulthood SES. Our approach is largely exploratory, suspecting that the strongest mediators between childhood circumstances and mid-life physical and emotional well-being may be cognitive performance during school years, material and behavioural difficulties, and educational achievement. We also explore whether the effects of childhood circumstances on mid-life physical and emotional well-being differ between men and women.
SETTING/PARTICIPANTS: Data were from the National Child Development Study, a fully-representative British birth cohort sample of 17 415 people born in 1 week in 1958.
PRIMARY/SECONDARY OUTCOME MEASURES: Our four primary mid-life outcome measures are: cognitive performance, physical and emotional well-being and quality of life. Our intermediate adult outcomes are early-adulthood social class and educational/vocational qualifications.
Using structural equation modelling, we explore numerous pathways through childhood and early adulthood which are significantly linked to our outcomes. We specifically examine the mediating effects of the following: cognitive ability at ages 7, 11 and 16 years; childhood psychological issues; family material difficulties at age 7 years: housing, unemployment, finance; educational/vocational qualifications and social class position at age 42 years.We find that social class at birth has a strong indirect effect on the age 50 outcomes via its influence on cognitive performance in childhood and adolescence, educational attainment and mid-life social class position, together with small direct effects on qualifications and social class position at age 42 years. Teenage cognitive performance has a strong positive effect on later physical health for women, while educational/vocational qualifications have a stronger positive effect on emotional well-being for men.
Our findings provide an understanding of the legacy of early life on multiple aspects of mid-life health, well-being, cognition and quality of life, showing stronger mediated links for men from childhood social class position to early adult social class position. The observed effect of qualifications supports those arguing that education is positively associated with subsequent cognitive functioning.
本研究旨在探讨从中年到中年的幸福感、健康和认知的途径,这些途径与出生时的家庭社会经济地位(SES)、教育成就和成年早期 SES 有关。我们的方法主要是探索性的,怀疑童年环境与中年身体和情绪健康之间最强的中介因素可能是学校期间的认知表现、物质和行为困难以及教育成就。我们还探讨了童年环境对中年身体和情绪健康的影响在男性和女性之间是否存在差异。
背景/参与者:数据来自国家儿童发展研究,这是一项具有代表性的英国出生队列样本,共有 1958 年一周内出生的 17415 人。
主要/次要结果测量:我们的四个主要中年结果测量是:认知表现、身体和情绪健康以及生活质量。我们的成年中期结果是成年早期的社会阶层和教育/职业资格。
使用结构方程模型,我们探索了许多与我们的结果相关的童年和成年早期的途径。我们特别研究了以下方面的中介作用:7 岁、11 岁和 16 岁时的认知能力;儿童心理问题;7 岁时的家庭物质困难:住房、失业、财务;42 岁时的教育/职业资格和社会阶层地位。我们发现,出生时的社会阶层通过其对儿童和青少年时期认知表现、教育程度和中年社会阶层地位的影响,对 50 岁时的结果具有很强的间接影响,同时对 42 岁时的资格和社会阶层地位也有很小的直接影响。青少年认知表现对女性的身体健康有很强的积极影响,而教育/职业资格对男性的情绪健康有更强的积极影响。
我们的研究结果提供了对早期生活对中年健康、幸福感、认知和生活质量的多个方面的影响的理解,显示了从中年社会阶层地位到成年早期社会阶层地位的男性更强的中介联系。观察到的资格效应支持了那些认为教育与后续认知功能呈正相关的观点。