Growing up in poverty, growing old with multimorbidity in America, Britain, China, Europe and Indonesia: a retrospective and prospective study in 31 countries

The childhood poor in rich countries have reported worse cognitive, muscle and mental functions in old age. But it is uncertain whether the childhood poor around the world are at higher risks of multimorbidity because childhood recollections are often erroneous. METHODSSome 81,804 older adults over 50 years in 31 countries recalled their childhood conditions at ten to fourteen and prospectively reported their chronic conditions. Childhood conditions in Britain and Europe include numbers of books, rooms and people, presence of running hot water and central heating. Across in America, these are mostly replaced with financial hardship or family indebtedness, in China starvation to death due to government edict while in Indonesia presence of running cold water. Per prior practice childhood poverty is a latent construct of these error-laced recollections while multimorbidity is defined as at least two from a set of chronic conditions. Associations with multimorbidity are obtained with fixed effects probit model, controlling for age, education, wealth, marital status and youth illness. Extensive sensitivity analyses assessed robustness. RESULTSChildhood poverty associates with higher probabilities of multimorbidity (0.088, [95% confidence interval 0.057 - 0.118]) in 31 rich and developing countries. And women reported lower probabilities of multimorbidity (-0.071, [-0.096 - -0.047]). Frequencies of multimorbidity vary across countries, and likewise age profiles of multimorbidity in later life. DISCUSSIONEvidence is accumulating that childhood lasts a life time in rich and developing nations. The various childhood recollections indicating poverty show that the childhood poor grow old with more chronic conditions. Because population ageing is posing a momentous challenge across the world, more research is needed on the life course shaping of healthy ageing. But this strong evidence calls for urgent actions to eliminate child poverty on account of its lifelong rewards. [287 + 4233 words]