Early-Life Environmental Exposures and Height, Hypertension, and Cardiovascular Risk Factors Among Older Adults in India

Abstract

Environmental exposures like rainfall and temperature influence infectious disease exposure and nutrition, two key early-life conditions linked to later-life health. However, few tests of whether early-life environmental exposures impact adult health have been performed, particularly in developing countries. This study examines the effects of experiencing rainfall and temperature shocks during gestation and up through the first four years after birth on measured height, hypertension, and other cardiovascular risk factors using data on adults aged 50 and above (N = 1,036) from the 2007–2008 World Health Organization Study on Global Ageing and Adult Health (SAGE) and district-level meteorological data from India. Results from multivariate logistic regressions show that negative rainfall shocks during gestation and positive rainfall shocks during the postbirth period increase the risk of having adult hypertension and CVD risk factors. Exposure to negative rainfall shocks and positive temperature shocks in the postbirth period increases the likelihood of falling within the lowest height decile. Prenatal shocks may influence nutrition in utero, while postnatal shocks may increase exposure to infectious diseases and malnutrition. The results suggest that gestation and the first two years after birth are critical periods when rainfall and temperature shocks take on increased importance for adult health.

Notes

¹ Results were similar when a linear outcome measure with values ranging from 0 to 4 instead of 0 to 1 was used. This measure is similar to comorbidity indices or risk factor scores that use weighted or unweighted sums to indicate the risk and/or severity of disease (Charlson et al. 1994; Wilson et al. 1998).

² Models using the bottom-quartile cutoff for height are similar to those presented in the main text.

³ Prior studies of weather shocks used cut points ranging from the 5th to the 25th and from the 75th to the 95th percentiles (Adhvaryu, Chari, and Sharma 2013; Burke, Gong, and Jones 2014; Jayachandran 2006; Kumar, Molitor, and Vollmer 2014). Results using the 20th and 25th percentiles for negative shocks and the 75th and 80th percentiles for positive shocks are similar to those presented in the main text.

⁴ SAGE includes data on respondents’ current state of residence and whether they have always lived in their current village/town/city. Respondents who responded yes to the last item were designated never-movers, and their current state, district, and rural/urban status are assumed to be their state, district, and rural/urban status at birth.

⁵ Agricultural occupation indicates those classified as skilled agricultural and fishery workers (International Standard Classification of Occupations–88).

Additional information

Funding

This work was supported in part by the National Science Foundation Graduate Research Fellowship Grant No. DGE-0822, the Grand Challenges Canada Grant Project Grant 0072-03 to the grantee, the Trustees of the University of Pennsylvania, and a National Institute on Aging training grant to the Population Research Center at Duke University (T32 AG000139).