Links between early life socioeconomic status and old-age nutrition status

Introduction: Cumulative Inequality theory specifies that social systems generate inequality over the life course, leading to health inequalities in old age. We explore the relationship between childhood socioeconomic status (SES), educational attainment, and nutrition status in old age among a representative sample of elderly in Taiwan over a 10-year period.

Methods: Data were obtained from a longitudinal survey of Taiwanese elders (aged 60 or over in 1989, N=3511). Participants’ father’s educational attainment was used as an indicator of childhood SES. Nutrition status was evaluated by the Mini Nutritional Assessment (MNA), which was administered in 1999. To account for the deceased, multinomial logistic regression was used to model both the odds of “death” or “at risk of malnutrition” against the elderly with normal nutritional status by 1999. All the analyses were stratified by gender.

Results: Among the 3511 participants surveyed in 1989, 1486 had died by 1999 and another 392 were at risk of malnutrition, based on their scoring on the MNA. The multinomial logistic regression showed that, in addition to the participants’ own level of education, their father’s education attainment was associated with either their survival or nutritional status 10 years later. For the men who had an illiterate father, they were more likely to die over the10-year period (OR=1.31, p=0.017). On the otehr hand, a woman with an illiterate father was more likely to be malnutritional (OR=1.72, p=0.01) in old age.

Conclusions: We found significant associations between childhood SES and mortality and malnutrition in old age that is gender-specific.