Cumulative Childhood Adversity and Active Life Expectancy among U.S. Adults

Jennifer Karas Montez, Harvard University
Mark D. Hayward, University of Texas at Austin

Studies of the early-life origins of adult physical functioning and mortality risk find that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies generally assess functioning and mortality as distinct processes. We hypothesized that childhood disadvantages shorten lives and increase the number of years lived with functional problems, and that educational attainment could partly ameliorate childhood disadvantages. Using the 1998-2008 Health and Retirement Study, we examined these hypotheses for non-Hispanic whites and blacks 50 to 100 years of age using multistate life tables. Regardless of educational attainment, adults from disadvantaged childhoods lived fewer total years of life, fewer years of active life, and spent a greater percent of life functionally impaired compared with adults from advantaged childhoods. While more years of educational attainment did not overcome the consequences of childhood disadvantage, very low levels of education could erase the benefits of childhood advantage.