The impact of childhood living conditions on illness and mortality in adulthood

The aim was to explore the relationships between indicators of economic and social problems in childhood on the one hand and illness and mortality in adulthood on the other. In 1968 a representative sample of the Swedish population born 1906-1951 were interviewed about their childhood living conditions, among other things. Four indicators of adverse childhood living conditions were included. Two of these reflect economic circumstances (economic hardship; a large family, defined as four or more siblings), and two reflect social conditions (broken family; conflicts in the family). In 1981, 13 years later, this sample was re-interviewed. This allows for illness in 1981 to be related to reports of childhood conditions given in 1968. A follow-up of mortality for the period 1981-1984 was also conducted. When one controls for age, sex and father's social class, those exposed to economic as well as social problems during childhood are found to have a considerably higher risk of being ill as adults. Of the four factors analysed, conflicts in the family during upbringing is that most strongly related to illness later in life, as well as with mortality. Having a broken family, and, to some extent, economic hardship during childhood, are also clearly associated with illness later in life. These results also hold true when all four factors are included simultaneously in the model, and remain relatively unchanged when controlling for mental illness in 1968. The childhood period as a whole (i.e. to the age of 16) seems to be quite important for adult health in Sweden, and social problems during this period of life seem to be more important in this respect than economic ones. These findings are discussed in the light of the more biological implied by the contemporary literature. Two hypotheses for the underlying mechanisms are suggested, namely (1) a biologically increased susceptibility to illness caused directly by childhood problems and (2) unhealthy life careers triggered by childhood conditions, where the increased illness risk is the sum of several health-damaging factors. It is concluded that the findings presented here lend more support to the second of these hypotheses.