Early Life Adversity, Educational Attainment, and Cardiometabolic Risk Among Middle-Aged and Older Adults in the United States.

BACKGROUND: Early life adversity (ELA) is a known contributor to physiological dysregulation and chronic disease in adulthood. However, less is known about how specific ELA domains influence cardiometabolic dysregulation later in life, or whether these associations vary by race/ethnicity and educational attainment.

METHODS: We used nationally representative data from the 2006-2016 Health and Retirement Study (n = 19,747 adults aged > 50) to estimate generalized linear models assessing associations between five ELA domains and cardiometabolic risk scores (cMetS). Models were stratified by race/ethnicity (foreign-born Latino, U.S.-born Latino, non-Latino Black, non-Latino White) and adjusted for demographic, lifestyle, medication, and socioeconomic covariates. Interaction terms tested whether educational attainment moderated these associations.

RESULTS: Childhood socioeconomic disadvantage was associated with higher cMetS in the full sample and among foreign-born Latino and non-Latino White adults, but not among U.S.-born Latino or non-Latino Black adults. Among individuals exposed to early adversity, educational attainment was associated with lower cMetS, though educational gradients varied by race/ethnicity. Non-Latino White adults demonstrated consistent educational protection across all adversity domains. Non-Latino Black adults showed educational buffering limited to childhood socioeconomic disadvantage and disruptive home environments. Among foreign-born Latinos, educational gradients were observed specifically for childhood socioeconomic disadvantage. U.S.-born Latinos showed no statistically significant educational buffering.

CONCLUSIONS: Early socioeconomic disadvantage has enduring effects on cardiometabolic health, and education can buffer these effects. However, education's protective capacity varies across populations. Addressing life course adversity in aging populations requires attention to both early disadvantage and social contexts that determine who can translate educational achievements into health benefits.