Emotional and Instrumental Support in Childhood and Allostatic Load in Mid-Life

Background and Objective:Extensive evidence shows that individuals who experience adversity during childhood face increased risk for a wide range of chronic disease of aging; less is known about protective factors during childhood that may decrease susceptibility to chronic diseases later in life. We examined the association between emotional and instrumental support during childhood and dysregulation of multiple physiological systems.

Methods: Data are from participants in the second wave of the Midlife and Aging in the United States study (MIDUS) who participated in a clinic-based comprehensive assessment of health status. Emotional and instrumental support during childhood was measured using 7 items based on participant retrospective self-report (alpha=0.89) and individuals were assigned to quartiles. Biological dysregulation was assessed using an allostatic load (AL) score constructed from 24 biologic measures across seven physiological systems (N=1,237, aged 34-84 years). Generalized estimating equations were used to account for siblings in the sample, and to adjust for potential confounders.

Results:Emotional and instrumental support in childhood was associated with lower AL in mid-life in a monotonic fashion: compared to individuals in the lowest quartile of support,  respondents in the second, third, and fourth quartiles had -0.08 (standard deviation [SD]=0.08), -0.13 (SD=0.08) and -0.21 (SD=0.08) units lower AL, adjusting for participant’s age, sex, and race. This pattern was maintained after adjustment for social desirability reporting bias, childhood socioeconomic disadvantage, current depression, and physician-diagnosed cardiovascular disease or diabetes (p<.01). Analyses to consider the seven physiological systems of the AL score separately showed the most pronounced patterns for the inflammation and metabolic-lipid subscales.

Conclusions: Using a national population-based sample, we identify a protective association between emotional and instrumental support in childhood and biological dysregulation in mid-life, even after accounting for socioeconomic disadvantage in childhood and a range of other potential confounders. Our findings suggest that family support may protect individuals from chronic disease risk several decades later. Prevention efforts aimed at reducing chronic diseases in mid-life should incorporate attention to protective factors within childhood social environments.