The "long arm of childhood" on mortality in older adulthood in the United States and Brazil: examining the role of educational attainment and differences by gender.

Early life conditions are associated with later life health. However, research in this area has been based on high-income countries, with limited research in low- and middle-income countries. We examine how childhood conditions are associated with mortality in older adulthood in the United States and Brazil, while evaluating the role of educational attainment and gender differences. Data come from the HRS and ELSI-Brazil. We use structural equation modeling to examine direct and indirect pathways from childhood conditions to mortality in older adulthood for men and women. Results showed substantial differences between Brazil and the United States. Childhood health was associated with increased mortality risk in the United States, not in Brazil. Adverse childhood conditions were associated with increased mortality in Brazil and the United States, but we found a large indirect pathway through educational attainment in the United States. Lastly, we found notable gender differences across both countries, with indirect pathways for United States men and Brazilian women (not their counterparts). Findings point to the malleability of the association of childhood conditions on adulthood mortality risk. Future work should consider how exposures and opportunities combine to influence life course developments of health and aging processes in diverse populations. This article is part of a Special Collection on Cross-National Gerontology.