Childhood poverty indicator for women

Women with disadvantaged childhoods are more likely to have a heart attack in old age, but men who grow up under similar conditions are not, indicates a study by sociologists from Duke University, Durham, N.C.

The link between childhood poverty and poor health in old age is well-established, but this is one of a handful of studies to find a difference in the way men and women respond--in part because it examines the sexes separately. "Traditionally, we have studied men," says lead author Jenifer Hamil-Luker, a post-doctoral fellow in sociology. "So we're just starting to see these gender differences."

The sociologists found, for example, that working mothers have a higher risk of heart attack, while working fathers' risk is decreased. "Existing research often overlooks key factors that influence women's health, such as the demands of child care or her social position, instead of just her husband's," Hamil-Luker points out. "Previous studies ignored the possibility that the complex interplay of biologic, social, psychological, economic, and behavioral processes that affect health may operate differently for men and women."

The researchers looked specifically at the risk of heart attack since the link between childhood poverty and cardiovascular disease in later life is particularly strong, and because heart attacks are so common. Heart attacks and cardiovascular disease have been the leading cause of death among American men and women since 1919.

They found that women who grew up in poor homes were 15% more likely to have had a heart attack in their 50s than females who did not experience such disadvantages. The study uncovered no such link for men. In addition, women who grew up without a father were 12% more likely to have had a heart attack in their 50s; males who grew up in fatherless homes did not have an increased risk of heart attack.

In men and women, living in poverty as a child was associated with adult behavior and conditions that can endanger health, such as smoking, poor exercise habits, and obesity. They also were more likely to have dangerous or service jobs, lack health insurance, and have low incomes. For women, however, education level and factors such as working in service jobs and dissatisfaction with friendships more strongly predict heart attack risk than they do for men.

Now that the link has been established, Hamil-Luker stresses that more study is needed to better understand why men and women react differently to disadvantage in childhood, and the mechanism by which the socioeconomic environment and genetic predisposition interact to influence health. "If we are to understand how the body acts as a repository of past experiences, we need data that wilL allow us to study the biosocial processes that shape health from infancy to adulthood."

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