Relative and absolute wealth mobility since birth in relation to health and human capital in middle adulthood: An analysis of a Guatemalan birth cohort

Jithin Sam Varghese; Shivani A Patel; Reynaldo Martorell; Manuel Ramirez-Zea; Aryeh D Stein

doi:10.1016/j.ssmph.2021.100852

Relative and absolute wealth mobility since birth in relation to health and human capital in middle adulthood: An analysis of a Guatemalan birth cohort

SSM Popul Health. 2021 Jun 19:15:100852. doi: 10.1016/j.ssmph.2021.100852. eCollection 2021 Sep.

Authors

Jithin Sam Varghese¹, Shivani A Patel², Reynaldo Martorell², Manuel Ramirez-Zea³, Aryeh D Stein²

Affiliations

¹ Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta GA, USA.
² Hubert Department of Global Health, Emory University, Atlanta GA, USA.
³ INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala.

Abstract

Background: Wealth mobility, as both relative (positional) and absolute (material) wealth acquisition, may counteract negative consequences of early life adversities on adult health.

Methods: We use longitudinal data (1967-2018) from the INCAP birth cohort, Guatemala (n = 1386). Using wealth as a measure of socio-economic position, we assess the association of life course relative mobility using latent class analysis and absolute material gains using conditional wealth measures. We estimate associations of wealth mobility with indicators of human capital, specifically height, weight status (BMI in kg/m²), psychological distress (WHO SRQ-20 score) and fluid intelligence (Ravens Progressive Matrices score; RPM) in middle adulthood.

Results: We identified four latent classes of relative mobility - Stable Low (n = 498), Stable High (n = 223), Downwardly Mobile (n = 201) and Upwardly Mobile (n = 464). Attained schooling (years) was positively associated with membership in Upwardly Mobile (odds ratio; 1.50, 95%CI: 1.31, 1.71) vs Stable Low, and inversely with membership in Downwardly Mobile (0.65, 95%CI: 0.54, 0.79) vs Stable High. Being Upwardly Mobile (vs Stable Low) was positively associated with height (1.88 cm, 95%CI: 1.04, 2.72), relative weight (1.32 kg/m², 95%CI: 0.57, 2.07), lower psychological distress (-0.82 units, 95%CI: 1.34, -0.29) and fluid intelligence (0.94 units, 95%CI: 0.28, 1.59). Being Downwardly Mobile (vs Stable High) was associated with lower fluid intelligence (-2.69 units, 95%CI: 3.69, -1.68), and higher psychological distress (1.15 units, 95%CI: 0.34, 1.95). Absolute wealth gains (z-scores) from early to middle adulthood were positively associated with relative weight (0.62 kg/m², 95%CI: 0.28, 0.96), lower psychological distress (-0.37 units, 95%CI: 0.60, -0.14) and fluid intelligence (0.50 units, 95%CI: 0.21, 0.79).

Conclusions: Higher attained schooling provided a pathway for upward relative mobility and higher absolute wealth gains as well as protection against downward relative mobility. Upward mobility was associated with lower psychological distress and higher fluid intelligence but also higher weight status.

Keywords: BMI, Body Mass Index; Conditional wealth; HIC, High income country; INCAP, Institute of Nutrition of Central America and Panama; LCA, Latent Class Analysis; LMIC, Low- and middle-income country; Latent class analysis; Life course socio-economic position; MAR, Missing at Random; PCA, Principal Component Analysis; SEP, Socio-economic position; SRQ-20, World Health Organization Self-Reporting Questionnaire-20; Social mobility.