Working paper no. 2010-01
The dramatic mortality decline of the 1930s-1960s in developing countries may have created a larger pool of adult survivors of poor childhood conditions. If hypotheses regarding the importance of early life exposures on adult health have merit, we would expect to observe that the health of older adults from these cohorts would be unduly influenced by these exposures. We examined this conjecture by selecting a cross-national sample of adults 60 years and older that were born during different stages (regimes) of mortality decline using data from major studies on aging in Latin America (Costa Rica, Mexico, major cities), the Caribbean (Puerto Rico, Cuba, Barbados), Asia (China, India, Indonesia, Bangladesh, Taiwan), the US, the UK and the Netherlands. We estimated the effects of education and household per capita income on heart disease, diabetes, obesity and poor self-reported health. We also used Waaler-type mortality surfaces to estimate expected relative risk of mortality and compared expected mortality risk by education and income level. Findings: (1) we found a very mixed pattern of steeper health disparities for heart disease, diabetes and obesity which did not always correspond with our expectation regarding older adults in countries most at risk of having suffered adverse childhood conditions; (2) a very clear pattern of disparities in expected relative risk of mortality based on height using Waaler-type surfaces. Implications: there is very weak evidence to suggest that countries which most probably produced a larger number of survivors of poor early childhood conditions as a result of public health interventions and medical technology largely in the absence of improvements in standard of living are also countries with steeper and stronger socioeconomic (SES) disparities among older adults.