Role of interpersonal relationships and early life socioeconomic conditions on morbidity in women in mid-life

Background: Socioeconomic circumstances in early life have been shown to shape adult interpersonal social experiences (interpersonal conflict, racial and gender discrimination) and adult health outcomes.

Method: Using a prospective, urban, birth cohort of U.S. women (38-45 years), we examined the association between socioeconomic status at birth (divided into tertiles of low, medium, and high) with lifetime racial discrimination reported in adulthood and adult morbidity (heart disease, asthma, thyroid disease, arthritis, pain, cancer). Morbidity was classified as no disease, single disease, or multiple diseases.

Results: Sixty-percent of the sample was non-white and 54% had less than a college degree. Twenty-seven percent reported having a single disease and 31% had multiple diseases. Thirty-nine percent of the sample reported experiencing racial discrimination. We observed a U-shaped association between childhood socioeconomic status and the reporting of racial discrimination in adulthood (X2=5.3, p=0.3). Reporting 1-2 cases of racial discrimination was associated with increased risk of morbidity in mid-life (RR=2.5, CI 1.0-6.3 for reporting one morbidity and RR=2.6, CI 1.1-6.2 for multiple diseases). Analyses restricted to heart disease revealed similar findings. Heart disease was positively associated with 1-2 reports of racial discrimination (RR=2.6, CI 1.0-6.8). We also found that women born into the second tertile of socioeconomic status were more likely to have heart disease in comparison to those born into the highest tertile of socioeconomic status (p=0.04).

Conclusion: If replicated, our results suggest that there is significant morbidity associated with racial discrimination and that the latter may be associated with socioeconomic status in early life.