Study shows childhood experiences have long-term effects on health in midlife

Nurturing mothers have garnered accolades for rescuing skinned knees on the playground and coaxing their children to sleep with lullabies. Now they're gaining merit for their offspring's physical health in middle age.

In a recent study published in the journal Psychological Science, Brandeis psychologist Margie Lachman with Gregory Miller and colleagues at the University of British Columbia and the University of California, Los Angeles reveal that while children raised in families with low socioeconomic status (SES) frequently go on to have high rates of chronic illness in adulthood, a sizable minority remain healthy across the life course. The research sought to examine if parental nurturance could mitigate the effects of childhood disadvantage.

Lachman, the Minnie and Harold Fierman Professor of Psychology, and director of the Lifespan Initiative on Healthy Aging, says that her team is working to understand the sources of social disparities in health and what can be done to reduce them. Funded by the National Institute on Aging as part of the Midlife in the United States (MIDUS) study, this information will then be used to empower families through education.

"The literature is very clear that people who are low in socioeconomic status have worse health than their same age counterparts," says Lachman, a phenomenon called the social gradient in health. "Modifiable factors play an important role, and we are realizing that things can be done to try to minimize these health disparities."

Clearly money and health care access are part of it, she says, but numerous studies show they play a very small role, as countries with universal health care have the same social gradient.

While they have looked at income in other studies, the team has found that the level of educational attainment is a more reliable indicator of socioeconomic status; people who have a college education do well in many areas, such as physical health, psychological well-being and cognitive function. Her team is looking for ways to reduce the differences, as not all lower-socioeconomic status people fare the same - some, Lachman says, are physically and cognitively active and have good social support, resources which seems to reduce their risks for poorer functioning.

The study is innovative in several ways. Other studies look at SES in adulthood and link it with self-reports of health. This study looked at SES during childhood and whether it predicted poor health many years later. The study also examined risk factors for cardiovascular disease and diabetes within the context of a large survey.

More than 1,000 members of the nationally representative sample were brought to a medical clinic for an overnight stay and samples were taken to assess pre-clinical indicators of disease. To qualify for a metabolic syndrome diagnosis, which is a precursor to coronary artery disease, Type 2 diabetes and stroke, adults had to have central adiposity (large waist circumference) and at least two of the following: high blood pressure, raised triglycerides, raised fasting glucose levels, or low levels of high-density lipoprotein (a specific cholesterol reading).

Emerging literature reveals that many of the health problems in midlife, including metabolic syndrome, can be traced back to what happened in early childhood. The stresses of childhood can leave a biological residue that shows up in midlife, explains Lachman. Yet, among those at risk for poor health, adults who had nurturing mothers in childhood fared better in physical health in midlife.

"Perhaps it's a combination of empathy, the teaching of coping strategies or support for enrichment," says Lachman. "We want to understand what it is about having a nurturing mother that allows you to escape the vulnerabilities of being in a low socioeconomic status background and wind up healthier than your counterparts."

The study has followed the same 1,205 people for over a decade. Nurturance was assessed with data and included questions such as: How much did she understand your problems and worries and how much time and attention did she give you when you needed it?

"We would like to try to use this information to bolster vulnerable families who are at risk for not doing well," says Lachman. "Teaching them parenting skills to show children concern for their welfare, how to cope with stress, that they have some control over their destinies, and how to engage in health-promoting behaviors such as good diet and exercise - the things that could protect against metabolic syndrome."

There still may be steps that can be taken later in life to reduce risk for those who are vulnerable, Lachman says.

Interestingly, in this study, paternal nurturing did not contribute to resilience.

"It could be that the results are tied to the particular cohort studied, and there may be generational differences," says Lachman. "With this cohort, people who are now in midlife, fathers weren't typically very involved. Paternal nurturance may play more of a role for the children of these midlife fathers who, in contrast, are more involved in the lives of their children and perhaps more nurturant."

As the study continues they will be able to look at new generations of middle-aged adults who have had different parenting experiences.

"The fact that we can see these long-term effects from childhood into midlife is pretty dramatic," says Lachman. "Yet this study is just one small piece of this overall puzzle. The more modifiable factors that can be identified, the more likely it is that we will be able to intervene successfully to optimize health."

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