Abstract

Based on unique data from the largest-ever sample of the Chinese oldest-old aged 80 and older, our multivariate logistic regression analyses show that either receiving adequate medical service during sickness in childhood or never/rarely suffering from serious illness during childhood significantly reduces the risk of being ADL (activities of daily living) impaired, being cognitively impaired, and self-reporting poor health by 18%–33% at the oldest-old ages. Estimates of effects for five other indicators of childhood conditions are similarly positive but mostly not statistically significant. Multivariate survival analysis shows that better childhood socioeconomic conditions in general tend to reduce the four-year period mortality risk among the oldest-old. But after additional controls for 14 covariates are put into the model, the effects are not statistically significant, thus suggesting that most of the effects of childhood conditions on oldest-old mortality are indirect—at least to the point of affecting current health status at the oldest-old ages, which itself is strongly associated with mortality. While acknowledging limitations of the present analyses due to a lack of information on childhood illness, the oldest-olds’ recollection errors, and other data problems, we conclude, based on this and other studies, that policies that enhance childhood health care and children’s socioeconomic wellbeing can have large and long-lasting benefits up to the oldest-old ages.

An erratum to this article is available at http://dx.doi.org/10.1353/dem.2007.0042.

References

Ahlburg, D., E. Jensen, and Y. Liao. 2004. “When I’m 104: The Determinants of Healthy Longevity Among the Oldest-Old in China.” Paper presented at Workshop on Determinants of Healthy Longevity in Chin at the Max Planck Institute for Demographic Research (MPIDR), Rostock, Germany, August 2–4.
Allison, P. (
2002
).
Missing Data
.
Thousand Oaks, CA
:
Sage Publications
.
Amaducci, L., Maggi, S., Langlois, J., Minicuci, N., Baldereschi, M., Di Carlo, A., & Grigoletto, F. (
1998
).
Education and the Risk of Physical Disability and Mortality Among Men and Women Aged 65 to 84: The Italian Longitudinal Study on Aging
.
Journal of Gerontology: Biological Science and Medical Science
,
5
,
M484
M490
.
Barker, D.J.P., Clark, P.M.S., Cox, L.J., Fall, C., Osmond, C., & Winter, P.D. (
1991
).
Fetal and Infant Growth and Impaired Glucose Tolerance at Age 64
.
British Medical Journal
,
303
,
1019
23
. 10.1136/bmj.303.6809.1019
Barker, D.J.P., Winter, P.D., Osmond, C., Margetts, B., & Simmonds, S.J. (
1989
).
Weight in Infancy and Death From Ischaemic Heart Disease
.
Lancet
,
2
,
577
80
. 10.1016/S0140-6736(89)90710-1
Beebe-Dimmer, J., Lynch, J.W., Turrell, G., Lustgarten, S., Raghunathan, T., & Kaplan, G.A. (
2004
).
Childhood and Adult Socioeconomic Conditions and 31-Year Mortality Risk in Women
.
American Journal of Epidemiology
,
159
,
481
90
. 10.1093/aje/kwh057
Buck, C., & Simpson, H. (
1982
).
Infant Diarrhea and Subsequent Mortality From Heart Disease and Cancer
.
Journal of Epidemiology and Community Health
,
36
,
27
30
. 10.1136/jech.36.1.27
Campbell C. and J. Lee. 2006. “Long-Term Consequences of Conditions in Childhood in Liaoning, China, 1749–1909.” Paper presented at the Conference on Longevity: Early-Life Conditions, Social Mobility and Other Factors That Influence Survival to Old Age, organized by Committee on Historical Demography of International Union for the Scientific Study of Population, Lund, Sweden, June 8–10.
Chen, J. and Z. Wu. 2004. “Gender Differences in the Effects of Self-rated Health Status on Mortality Among Chinese Oldest-Old.” Paper presented at the Conference on Chinese Healthy Aging and Socioeconomics: International Perspectives, Duke University, Durham, NC, August 20–21.
Christensen, K., Vaupel, J.W., Holm, N.V., & Yashin, A.I. (
1995
).
Mortality Among Twins After Age 6: Fetal Origins Hypothesis Versus Twin Method
.
British Medical Journal
,
310
,
432
36
.
Coale, A., & Li, S. (
1991
).
The Effect of Age Misreporting in China on the Calculation of Mortality Rates at Very High Ages
.
Demography
,
28
,
293
301
. 10.2307/2061281
Crimmins, E.M., Hayward, M.D., & Saito, Y. (
1994
).
Changing Mortality and Morbidity Rates and the Health Status and Life Expectancy of the Older Population
.
Demography
,
31
,
159
75
. 10.2307/2061913
Deb, S., & Braganza, J. (
1999
).
Comparison of Rating Scales for the Diagnosis of Dementia in Adults With Down’s Syndrome
.
Journal of Intellectual Disability Research
,
43
,
400
407
. 10.1046/j.1365-2788.1999.043005400.x
Dilorio, C., Hartwell, T., & Hansen, N. (
2002
).
Childhood Sexual Abuse and Risk Behaviors Among Men at High Risk for HIV Infection
.
American Journal of Public Health
,
92
,
214
19
. 10.2105/AJPH.92.2.214
Elder, G.H., Shanahan, M.J., & Clipp, E.C. (
1994
).
When War Comes to Men’s Lives: Life Course Patterns in Family, Work, and Health
.
Psychology and Aging, Special Issue
,
9
(
1
),
5
16
. 10.1037/0882-7974.9.1.5
Elford, J., Whincup, P., & Shaper, A.G. (
1991
).
Early Life Experience and Adult Cardiovascular Disease: Longitudinal and Case-Control Studies
.
International Journal of Epidemiology
,
20
,
833
44
. 10.1093/ije/20.4.833
Elo, I.T., & Preston, S.H. (
1992
).
Effect of Early Life Conditions on Adult Mortality: A Review
.
Population Index
,
58
(
2
),
186
212
. 10.2307/3644718
Everson-Rose, S.A., de Leon, C.F.M., Bienias, J.L., Wilson, R.S., & Evan, D.A. (
2003
).
Early Life Conditions and Cognitive Functioning in Later Life
.
American Journal of Epidemiology
,
158
,
1083
89
. 10.1093/aje/kwg263
Older Americans 2000: Key Indicators of Well-being
. (
2003
).
Hyattsville, MD
:
National Center for Health Statistics
.
Feldman, J., Makuc, D., Kleinman, J., & Cornoni-Huntley, J. (
1989
).
National Trends in Educational Differentials in Mortality
.
American Journal of Epidemiology
,
129
,
919
33
.
Finch, C.E., & Crimmins, E.M. (
2004
).
Inflammatory Exposure and Historical Changes in Human Life-spans
.
Science
,
305
,
1736
39
. 10.1126/science.1092556
Fogel, R.W. (
1993
).
New Sources and New Techniques for the Study of Secular Trends in Nutritional Status, Health, Mortality and the Process of Aging
.
Historical Methods
,
26
,
5
43
.
Fogel, R.W., & Costa, D.L. (
1997
).
A Theory of Technophysio Evolution, With Some Implications for Forecasting Population, Health Care Costs, and Pension Costs
.
Demography
,
34
,
49
66
. 10.2307/2061659
Folstein, M.F, Folstein, S.E., & McHugh, P.R. (
1975
).
Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician
.
Journal of Psychiatric Research
,
12
(
3
),
189
98
. 10.1016/0022-3956(75)90026-6
Gluckman, P.D., & Hanson, M.A. (
2004
).
Living With the Past: Evolution, Development, and Patterns of Disease
.
Science
,
305
,
1733
36
. 10.1126/science.1095292
Graham, H. (
2002
).
Building an Inter-disciplinary Science of Health Inequities: The Example of Lifecourse Research
.
Social Science & Medicine
,
55
,
2005
16
. 10.1016/S0277-9536(01)00343-4
Grambsch, P.M., & Therneau, T.M. (
1994
).
Proportional Hazards Tests and Diagnostics Based on Weighted Residuals
.
Biometrika
,
81
,
515
26
. 10.1093/biomet/81.3.515
Gu, D., & Yi, Zeng (
2004
).
Data Quality Assessment of the CLHL1998, 2000, and 2002 Waves
. In Yi, Zeng, Liu, Y., Zhang, C., & Xiao, Z. (Eds.),
Analyses of the Determinants of Healthy Longevity
(pp.
4
22
).
Beijing
:
Peking University Press
.
Hart, C., Smith, G.D., & Blane, D. (
1998
).
Social Mobility and 21-Year Mortality in a Cohort of Scottish Men
.
Social Science & Medicine
,
47
,
1121
30
. 10.1016/S0277-9536(98)00061-6
Hasle, H. (
1990
).
Association Between Living Conditions in Childhood and Myocardial Infarction
.
British Medical Journal
,
300
,
512
13
. 10.1136/bmj.300.6723.512
Hayward, M.D., & Gorman, B.K. (
2004
).
The Long Arm of Childhood: The Influence of Early-Life Social Conditions on Men’s Mortality
.
Demography
,
41
,
87
107
. 10.1353/dem.2004.0005
Hill, T., Angel, J., Ellison, C., & Angel, R. (
2005
).
Religious Attendance and Mortality: An 8-Year Follow-up of Older Mexican Americans
.
Journal of Gerontology: Psychological Sciences & Social Sciences
,
60B
,
S102
S109
.
Idler, E.L., & Benyamini, Y. (
1997
).
Self-rated Health and Mortality: A Review of Twenty-seven Community Studies
.
Journal of Health and Social Behavior
,
38
,
21
37
. 10.2307/2955359
Jagger, C., Arthur, A.J., Spiers, N.A., & Clarke, M. (
2001
).
Patterns of Onset of Disability in Activities of Daily Living With Age
.
Journal of the American Geriatric Society
,
49
,
404
409
. 10.1046/j.1532-5415.2001.49083.x
Jenkins, M.A., Hopper, J.L., Bowes, G., Carlin, J.B., Flander, L.B., & Giles, G.G. (
1994
).
Factors in Childhood as Predictors of Asthma in Adult Life
.
British Medical Journal
,
309
,
90
93
.
Kannisto, V., Christensen, K., & Vaupel, J.W. (
1997
).
No Increased Mortality in Later Life for Cohorts Born During Famine
.
American Journal of Epidemiology
,
145
,
987
94
.
Katz, S., Ford, A.B., Moskowitz, R.W., Jackson, B.A., & Jaffe, M.W. (
1963
).
Studies of Illness in the Aged. The Index of ADL: A Standardized Measure of Biological and Psychosocial Function
.
Journal of the American Medical Association
,
185
(
12
),
914
19
.
Koenig, H.G., Hays, J.C., Larson, D., George, L.K., Cohen, H.J., McCullough, M.E., Meador, K.G., & Blazer, D.G. (
1999
).
Does Religious Attendance Prolong Survival? A Six-Year Follow-up Study of 3,968 Older Adults
.
Journal of Gerontology: Medical Science
,
54A
(
7
),
M370
M376
. 10.1093/gerona/54.7.M370
Kohler, I. and B.J. Soldo. 2004. “Early Life Events and Health Outcomes in Late Life in Developing Countries—Evidence From the Mexican Health and Aging Study.” Paper presented at the annual meeting of the Population Association of America, Boston, March 29–April 1.
Kramer, M.S., & Joseph, K.S. (
1996
).
Enigma of Fetal/Infant-Origins Hypothesis
.
Lancet
,
348
,
1254
55
. 10.1016/S0140-6736(05)65750-9
Kuh, D., & Ben-Shlomo, Y. (
2004
).
A Life Course Approach to Chronic Disease Epidemiology
. 2nd ed.
Oxford, England
:
Oxford University Press
.
Kuh, D., Hardy, R., Langenberg, C., Richards, M., & Wadsworth, M.E.J. (
2002
).
Mortality in Adults Aged 26–54 Years Related to Socioeconomic Conditions in Childhood and Adulthood: Post War Birth Cohort Study
.
British Medical Journal
,
325
,
1076
80
. 10.1136/bmj.325.7372.1076
Kumaran, K., Fall, C.H.D., Martyn, C.N., Vijayakumar, M., Stein, C., & Shier, R. (
2000
).
Blood Pressure, Arterial Compliance, and Left Ventricular Mass: No Relation to Small Size at Birth in South Indian Adults
.
Heart
,
83
,
272
77
. 10.1136/heart.83.3.272
Lauderdale, D.S. (
2001
).
Education and Survival: Birth Cohort, Period, and Age Effects
.
Demography
,
38
,
551
61
. 10.1353/dem.2001.0035
Leinonen, R., Heikkinen, E., & Jylha, M. (
2001
).
Predictors of Decline in Self-assessments of Health Among Older People—A 5-year Longitudinal Study
.
Social Science and Medicine
,
52
,
1329
41
. 10.1016/S0277-9536(00)00249-5
Lucas, A., & Morley, R. (
1994
).
Does Early Nutrition in Infants Born Before Term Programme Later Blood Pressure?
.
British Medical Journal
,
309
,
304
308
.
Luo, Y., & Waite, L.J. (
2005
).
The Impact of Childhood and Adult SES on Physical, Mental, and Cognitive Well-being in Later Life
.
Journal of Gerontology: Psychological Sciences & Social Sciences
,
60B
(
2
),
S93
S101
.
Lynch, J.W., Kaplan, G.A., Cohen, R.D., Kauhanen, J., Wilson, T.W., Smith, N.L., & Salonen, J.T. (
1994
).
Childhood and Adult Socioeconomic Status as Predictors of Mortality in Finland
.
Lancet
,
343
,
524
27
. 10.1016/S0140-6736(94)91468-0
Lynch, J.W., Kaplan, G.A., & Salonen, J.T. (
1997
).
Why Do Poor People Behave Poorly? Variations in Adult Health Behavior and Psychological Characteristics by Stage of the Socioeconomic Life-course
.
Social Science & Medicine
,
44
,
809
20
. 10.1016/S0277-9536(96)00191-8
Magaziner, J., Bassett, S.S., Hebel, J.R., & Gruber-Baldini, A. (
1996
).
Use of Proxies to Measure Health and Functional Status in Epidemiologic Studies of Community-Dwelling Women Aged 65 Years and Older
.
American Journal of Epidemiology
,
12
,
283
92
.
Martelin, T., Koskinen, S., & Valkonen, T. (
1998
).
Socio-demographic Mortality Differences Among the Oldest Old in Finland
.
Journal of Gerontology: Social Sciences
,
53B
(
2
),
S83
S90
.
Mathews, J.D., Whittingham, S., & Mackay, I.R. (
1974
).
Autoimmune Mechanisms in Human Vascular Disease
.
Lancet
,
2
,
1423
27
. 10.1016/S0140-6736(74)90077-4
Matthes, J.W.A., Lewis, P.A., Davies, D.P., & Bethel, J.A. (
1994
).
Relation Between Birth Weight and Systolic Blood Pressure in Adolescence
.
British Medical Journal
,
308
,
1074
77
.
O’Rand, A.M., & Hamil-Luker, J. (
2005
).
Processes of Cumulative Adversity: Childhood Disadvantage and Increased Risk of Heart Attack Across the Life Course
.
Journals of Gerontology: Psychological Sciences & Social Sciences
,
60B
(
Special Issue II
),
117
24
.
Preston, S.H., Hill, M.E., & Drevenstedt, G.L. (
1998
).
Childhood Conditions That Predict Survival to Advanced Ages Among African-Americans
.
Social Science and Medicine
,
47
,
1231
46
. 10.1016/S0277-9536(98)00180-4
Preston, S.H., & Taubman, P. (
1994
).
Socioeconomic Differences in Adult Mortality and Health Status
. In Martin, L.G., & Preston, S.H. (Eds.),
Demography of Aging
(pp.
279
318
).
Washington, DC
:
National Academic Press
.
Seidman, D.S., Laor, A., Gale, R., Stevenson, D.K., Mashiach, S., & Danon, Y.L. (
1991
).
Birth Weight, Current Body Weight and Blood Pressure in Late Adolescence
.
British Medical Journal
,
302
,
1235
37
. 10.1136/bmj.302.6787.1235
Smith, J.B., & Kington, R. (
1997
).
Demographic and Economic Correlates of Health in Old Age
.
Demography
,
34
,
159
70
. 10.2307/2061665
The State of the World’s Children 2002
. (
2002
).
Geneva
:
UNICEF
.
Verbrugge, L.M., & Jette, A.M. (
1994
).
The Disablement Process
.
Social Science and Medicine
,
38
(
1
),
1
14
. 10.1016/0277-9536(94)90294-1
Wang, Z., Zeng, Y., Jeune, B., & Vaupel, J.W. (
1998
).
Age Validation of Han Chinese Centenarians
.
Genus
,
54
(
1–2
),
123
41
.
Wannamethee, G., & Shaper, A.G. (
1991
).
Self-assessment of Health Status and Mortality in Middle-aged British Men
.
International Journal of Epidemiology
,
20
,
239
45
. 10.1093/ije/20.1.239
Whincup, P.H., Cook, D.G., & Papacosta, O. (
1992
).
Do Maternal and Intrauterine Factors Influence Blood Pressure in Childhood?
.
Archives of Disease in Childhood
,
67
,
1423
29
. 10.1136/adc.67.12.1423
The First Ten Years of the WHO
. (
1958
).
Geneva
:
WHO
.
Yu, E.S., Kean, Y.M., Slymen, D.J., Liu, W.T., Zhang, M., & Katzman, R. (
1998
).
Self-perceived Health and 5-Year Mortality Risks Among the Elderly in Shanghai, China
.
American Journal of Epidemiology
,
147
,
880
90
.
Zeng, Yi, & Vaupel, J.W. (
2002
).
Functional Capacity and Self-Evaluation of Health and Life of the Oldest Old in China
.
Journal of Social Issues
,
58
,
733
48
. 10.1111/1540-4560.00287
Zeng, Yi (
2004
).
Association of Late Childbearing With Healthy Longevity Among the Oldest-Old in China
.
Population Studies
,
58
(
1
),
37
53
. 10.1080/0032472032000175437
Zeng, Yi, Vaupel, J.W., Xiao, Z., Zhang, C., & Liu, Y. (
2001
).
The Healthy Longevity Survey and the Active Life Expectancy of the Oldest Old in China
.
Population: An English Selection
,
13
(
1
),
95
116
.
Zeng, Yi (
2002
).
Sociodemographic and Health Profiles of the Oldest Old in China
.
Population and Development Review
,
28
,
251
73
. 10.1111/j.1728-4457.2002.00251.x
Zhao, Z. 2004. “The Impact of Economic Factors on Mortality and Health at Oldest-Old Ages in China.” Paper presented at Workshop on Determinants of Healthy Longevity in Chin at the Max Planck Institute for Demographic Research (MPIDR), Rostock, Germany, August 2–4.