Original article
Early Socioeconomic Adversity and Young Adult Physical Illness: The Role of Body Mass Index and Depressive Symptoms

https://doi.org/10.1016/j.jadohealth.2014.04.006Get rights and content

Abstract

Purpose

The present study investigated the psychophysiological inter- and intra-individual processes that mediate the linkage between childhood and/or adolescent socioeconomic adversities and adult health outcomes. Specifically, the proposed model examined the roles of youth depressive symptoms and body mass index (BMI) trajectories as mediators that explain the link between early adversity and young adults' general health and physical illnesses after controlling for gender, race or ethnicity, and earlier general health reports.

Methods

Using a nationally representative sample of 12,424 from National Longitudinal Study of Adolescent Health (Add Health), this study used growth curve modeling to consider both the severity (initial level) and the change over time (deterioration or elevation) as psychophysiological mediators, thereby acknowledging multiple facets of depressive symptoms and BMI trajectories as psychophysiological mediators of early adversity to adult health.

Results

Results provide evidence for (1) the influence of early childhood and early adolescent cumulative socioeconomic adversity on both the initial levels and changes over time of depressive symptoms and BMI and (2) the independent influences depressive symptoms and BMI trajectories on the general health and the physical illnesses of young adults.

Conclusions

These findings contribute valuable knowledge to existing research by elucidating how early adversity exerts an enduring long-term influence on physical health problems in young adulthood; furthermore, this information suggests that effective intervention and prevention programs should incorporate multiple facets (severity and change over time) of multiple mechanisms (psychological and physiological).

Section snippets

Methodological concerns

Previous research has investigated life course models predicting health outcomes using traditional regression models. These models generally have not investigated intraindividual changes in health attributes over time. In the present study, we investigated individual trajectories of depressive symptoms and BMI as mediators because they allow interpretations of how early socioeconomic adversities influence not only the early levels (severity) but also the subsequent individual changes or slopes

Results

Table 2 presents correlations among study variables as well as descriptive statistics of main study variables. A slight positive skewness in physical illness at wave 4 was accounted for using the weighted least squares mean adjusted (type 5) estimator in MPlus.

Table 3 includes growth parameter estimates from unconditional univariate LGC models of depressive symptoms and BMI. The unconditional LGC model of depressive symptoms showed adequate model fit and significant means and variances of the

Discussion

The present study examined a life course model, from adolescence to adulthood, of the contemporaneous development of depression and BMI in relation to socioeconomic adversities. The results show that early socioeconomic adversity potentiates the development of BMI and depressive symptoms through adolescence and young adulthood, culminating in the physical illness of participants over this period of the life course. A key element in this model involved depressive symptoms and BMI trajectories

Acknowledgments

Persons interested in obtaining data files from The National Longitudinal Study of Adolescent Health should contact Add Health Project, Carolina Population Center, 123 West Franklin Street, Chapel Hill, NC 27516-3997 (e-mail: [email protected]).

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