Childhood Socioeconomic Status: A strong correlate of behavioral risk factors and disease in adulthood

Introduction: The life course perspective advocates for consideration of both environmental and psychosocial risk factors occurring over the lifetime to better explain disease etiology and the origins of health disparities. Childhood socioeconomic status is often used to represent the early life context in which these risk factors unfold. Objective: Determine the contribution of adding measures of childhood socioeconomic status (CSES) to the Behavioral Risk Factor Surveillance Survey (BRFSS). Methods: Using data from the Allegheny County BRFSS (N=5442), a population based telephone survey locally funded and supported by the Allegheny County Health Department, we examined the independent effects of CSES on health indicators assessed in the CDC BRFSS. CSES was measured using the highest level of education achieved by either parent. While controlling for respondent's age, gender, and race, logistic regression models were used to test for associations between CSES and behavioral risk factors and disease. Results: Of 30 indicators tested, CSES was significantly associated (p<.05) with 20 indicators. All significant associations were in the expected direction. Even when controlling for respondent's current SES, a likely mediator of the CSES effect, 13 indicators remained significant (Health Status, Healthcare Coverage, Diabetes, Hypertension, Current Smoking, Binge Drinking, Flu Vaccination, Obesity, Adverse Childhood Experiences, Serious Psychological Distress, Emotional Support, Physical Activity, and Consumption of Fruits/Vegetables). Conclusions: CSES, as a measure of early life circumstances and adversity, provides useful information concerning environmental and psychosocial factors experienced in childhood that have long-lasting and far-reaching health consequences. Future population based studies would benefit from including measures of CSES in their questionnaires.