Childhood socioeconomic disadvantage and risk of physical multimorbidity in later life: The mediating role of depression

Published:September 23, 2022DOI:


      • This is the first study to investigate whether depression mediates the association between childhood socioeconomic disadvantage and physical multimorbidity in adulthood.
      • Childhood socioeconomic disadvantage was associated with higher risks of depression and physical multimorbidity in later life, and females were more vulnerable to the adverse impact of childhood socioeconomic disadvantage on the risk of depression.
      • Depression mediated the association of childhood socioeconomic disadvantage with physical multimorbidity, especially among females.



      To assess the impact of childhood socioeconomic disadvantage (SED) on the risks of depression and physical multimorbidity in later life and to explore whether depression mediates the association between childhood SED and physical multimorbidity.


      Data on 8214 adults from the China Health and Retirement Longitudinal Study were analyzed. The mean (SD) age of the study population was 57.0 (8.0) years at baseline (2011) and 51.9 % were females. Multivariable logistic regressions were used to examine the associations of childhood SED (indexed by food insecurity, highest education level of parents, and self-perceived household financial situation, and scored 0–3) with later-life depression (scored ≥10 on the 10-item Center for Epidemiologic Studies Depression Scale) and physical multimorbidity (having two or more doctor-diagnosed chronic conditions) assessed in the 2018 follow-up survey. Mediation analysis was conducted in the overall sample and further stratified by sex to estimate the degree to which the association between childhood SED and physical multimorbidity could be explained by baseline depression.


      Participants with a childhood SED score of 3 (i.e., the most disadvantaged) had 2.63 (95 % confidence interval [CI]: 1.91–3.63) times and 2.08 (95 % CI: 1.56–2.77) times higher odds of depression and physical multimorbidity respectively compared with those who had a score of 0 (i.e., the least disadvantaged). Depression mediated 20 % of the association between childhood SED and physical multimorbidity (36 % in females and 5 % in males).


      Childhood SED was associated with higher risks of depression and physical multimorbidity in later life, and the association of childhood SED with physical multimorbidity was mediated by depression, especially among females.


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