Social-economic inequalities and early-life exposure to famine contribute to low grip strength: The China National Health Survey.

BACKGROUND AND AIM

The relationship between socio-economic inequalities (SEIs) and early life malnutrition with muscle health remains unclear. This study aims to examine the effects of SEIs and early life exposure to famine on relative hand grip strength (rHGS).

METHODS AND RESULTS

We analyzed data of 37,008 individuals from the China National Health Survey. SEI were assessed using the Population Attributable Fraction (PAF), the Relative Index of Inequality (RII), and the Slope Index of Inequality (SII). The propensity score matching and cohort size shrinkage index were used to examine the impact of famine on low rHGS. The RII for education- and income-based SEI was 1.17 (95 % CI: 1.09 to 1.27) and 1.20 (95 % CI: 1.11 to 1.29) in men, and 1.20 (95 % CI: 1.12 to 1.28) and 1.06 (95 % CI: 0.99 to 1.13) in women, respectively. The SII per 100,000 persons for education- and income-based SES was 609 (207-1011) and 912 (481-1343) in men, compared to 909 (580-1237) and 218 (-134 to 570) in women. The stimulation analysis showed that both RII and SII increased with a higher proportion of individuals at the highest income level, exhibiting a sex-differential pattern. Early-life exposure to famine was significantly associated with decreased rHGS. The PAFs of low rHGS attributed to famine ranged from 2.5 % to 4.6 % in men and 5.8 %-9.6 % in women.

CONCLUSIONS

SEI and early life malnutrition increased the risk of low rHGS. These findings are valuable for informing policymaking aimed at healthy aging.