Multiple Pathways Linking Early Socioeconomic Circumstances and Depressive Symptoms in Late Middle Age

Background and Purpose: A growing number of life course studies have begun to examine the influence of earlier life experiences on morbidity, disability, and mortality in mid-old age. In this study, using national prospective data in a structural equation model framework, we assess an empirical pathway linking childhood disadvantage to depressive symptoms in late-middle adulthood focusing on multiple mediators over different life stages (young adulthood and middle adulthood).

Methods: Drawing from the social pathway model, this study expands the life course literature by utilizing data collected over 35 years from the National Longitudinal Survey of Youth, 1979 Cohort (NLSY79), spanning four life course phases (childhood, young adulthood, middle adulthood, and late-middle adulthood). Through structural equation analyses with a phantom model, we estimated depressive symptoms in late middle age as a result of pathway effects starting with childhood socio-economic status (SES), which affect young adulthood and (early) middle adulthood. The multi-pathway life course model includes three potential mediators in middle adulthood: health risk behaviors, social activity, and negative life events. Date came from the respondents aged 14 to 18 in 1979 (born between 1957 and 1961) and followed until in their late-middle adulthood (aged 49-57 years of age in 2014) (N=4785 respondents).  

Results: We found limited support for a direct effect of childhood SES disadvantage on depressive symptoms in middle age. Instead, much of the effects of childhood SES on later-year depressive symptoms appeared to be mediated by SES in young adulthood. Further, the long-term pathway is mediated through the influence of health risk behaviors and negative life events in middle adulthood.

Conclusions and Implications: Our findings do not propose a permanent and irreversible influence of this chain. Rather, this study highlights the possibility that interventions focused on promoting health behaviors and improving living conditions for people from socioeconomically disadvantaged backgrounds could help reduce the instance of depression in middle age. Our study highlights the possibility that, by identifying and intervening in subsequent pathways in the chain of risks, health outcomes along the life course could be improved.