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International Journal of Public Health

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01-12-2017 | Original Article

Mediation of the effect of childhood socioeconomic position by educational attainment on adult chronic disease in Chile

Authors: Patricia Frenz, Jay S. Kaufman, Carolina Nazzal, Gabriel Cavada, Francisco Cerecera, Nicolás Silva

Published in: International Journal of Public Health | Issue 9/2017

Abstract

Objectives

We estimated the roles of childhood socioeconomic position (ChSEP) and education attainment on chronic diseases in Chilean adults, mediated through structural determinants and health behaviors, to identify potential pro-equity interventions.

Methods

We analyzed Chile’s longitudinal Social Protection Surveys, a national sample of 14,788 adults with follow-up to 2009. Controlled direct effects (CDE) and natural effects (NDE and NIE) of ChSEP and education on number of chronic diseases were estimated with negative binomial models.

Results

CDE of low ChSEP with education fixed at 12 years showed a 12% increase with 4% indirect effects. CDEs at favorable levels of BMI, smoking, alcohol use, and physical activity were similar. CDE estimates for education adjusted for ChSEP were larger with negligible mediation. CDEs for women were generally larger.

Conclusions

Low ChSEP exerts a primarily direct effect on later chronic disease, modestly mediated by education. Education attainment showed larger direct effects with minimal mediation by behaviors. Strengthening current–early child development and education policies, particularly gender aspects, may reduce social inequalities and key pathways for reducing chronic disease inequalities in Chile.

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Title: Mediation of the effect of childhood socioeconomic position by educational attainment on adult chronic disease in Chile
Authors: Patricia Frenz
Jay S. Kaufman
Carolina Nazzal
Gabriel Cavada
Francisco Cerecera
Nicolás Silva
Publication date: 01-12-2017
Publisher: Springer International Publishing
Published in: International Journal of Public Health / Issue 9/2017
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-017-0996-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Mediation of the effect of childhood socioeconomic position by educational attainment on adult chronic disease in Chile

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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