Mortality of the oldest old Chinese: The role of early-life nutritional status, socio-economic conditions, and sibling sex-composition

Abstract

Based on a nationally representative sample of 8,099 Chinese drawn from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study investigated the long-term health consequences of early-life nutritional status, sibling sex-composition, childhood socio-economic conditions, and place of birth on mortality at ages 80 and above between 1998 and 2005. Better nutritional status in childhood predicted lower mortality at ages 80 and above, net of childhood circumstances, adult socio-economic status, and health behaviours. In addition, sibling sex-composition had long-term health consequences, net of childhood and adult characteristics, such that women benefited from having grown up in families with only daughters, while men benefited from having grown up in families with both sons and daughters. Childhood socio-economic status was only marginally related to old-age mortality and this association was attenuated further by the inclusion of adult characteristics. Place of birth was not a significant predictor of old-age mortality.

Keywords:

• mortality
• oldest old
• sibling composition
• nutritional status
• arm length
• early life

Notes

1. Cheng Huang is at the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Grace Crum Rollins Building, 1518 Clifton Road, Atlanta, GA 30322, USA. E-mail: [email protected]. Irma T. Elo is at the Population Studies Center, Department of Sociology, The University of Pennsylvania.

2. The Chinese Longitudinal Healthy Longevity Survey (CLHLS) used for this study is managed by the Center for Healthy Aging and Family Studies, Peking University. The CLHLS is supported by a grant from National Institutes of Aging (NIA) (R01 AG23627-01: PI, Zeng Yi)) and by China Natural Science Foundation, China Social Science Foundation, UNFPA, and Hong Kong Research Grant Council. For their advice and comments on earlier drafts of this paper, the authors would like to thank Paul D. Allison, Beth J. Soldo, Solveig A. Cunningham, and three anonymous reviewers. Dr. Huang's post-doctoral fellowship is partially supported by an educational grant from Eli Lilly and Company.