Article Text
Abstract
Objectives The aim of this research was to estimate and compare the direct and indirect influence (mediated by respondents’ education) of three indicators of CSES (childhood financial conditions, mothers’ education, fathers’ education) on: i) the generic health dimensions included in the EQ-5D; ii) self-rated health (SRH), iii) age-comparative self-rated health (ASRH), and; iv) subjective wellbeing.
Method The data was analysed using Stata command Paramed. Log-linear regression was used for the health and life satisfaction outcomes to estimate the natural direct effects (NDE), natural indirect effects (NIE) and marginal total effects (MTE) as risk ratios (RR). Statistically significant interaction (p < 0.05) was observed between the CSES exposures and gender, regressed on the health and wellbeing outcomes, therefore the analysis was conducted separately for men and women.
Results Childhood financial conditions was associated (NDE) with all health measures. Men had a higher risk of being unhealthy on the composite EQ-5D measure, and the anxiety/depression dimension, but women had a higher risk of being unhealthy on the dimensions self-care, usual activities, pain/discomfort, as well as on SRH. Childhood financial conditions had no statistically (p > 0.05) significant NIE mediated by respondents’ education, on any health measure. While almost all NDEs of parental education on health outcomes were not statistically significant (p > 0.05), most of the NIEs of parental education were statistically significant (p < 0.05).
Conclusions Childhood financial conditions have a strong direct effect on later health and wellbeing, independent of respondents’ education, while parental education has an indirect effect on later health mediated by respondents’ education.