The Cost of Survival: Identifying Life Course Associations between Childhood and Adult Health Outcomes in the Skeletal Record

Abstract

A central concern in adult health is understanding the role that early health experiences, such as during childhood, may play in shaping later adult health outcomes. The aim of my research is to employ a life course approach to investigate possible associations between health insults experienced in childhood, between two and six years, and health outcomes in adulthood. In addition, I will also examine if, and how, adult health outcomes might be mediated or modified through biosocial aspects such as sex and socioeconomic status. This will be achieved through the analysis of human skeletal remains, involving the assessment of physiological stress indicators visible on both teeth and bone. Data are collected from 195 individuals from four London cemeteries spanning a range of socioeconomic positions and who lived during the Industrial Revolution (~1750 to 1850). Skeletal stress indicators associated with infancy and childhood, including cribra orbitalia and final long bone lengths, are used in conjunction with a dental indicator, enamel hypoplasia, which allows the frequency and timing of childhood health insults to be estimated. Adult health outcomes are assessed in term of periosteal new bone lesions, periodontitis, and age at death. These data are supplemented by parish burial records for two collections representing the highest and lowest socioeconomic groups (n = 9239). Findings suggest that childhood health insults can influence adult health but not in the manner expected. Here, the predominant impact of early stressors was beneficial to adult survival and acquired immunity is suggested as a key factor in this association. This effect is more pronounced in higher SES groups and it is likely an accumulation of risks across the life course exerted a stronger influence on lower SES individuals.