Childhood Family Income and Adult Cardiovascular Health: Indirect Effects Through Childhood Neighborhood Socioeconomic Advantages and Disadvantages in a Prospective Sample of Young Men

BACKGROUND: Childhood family income may impact men's cardiovascular health (CVH), partly through exposure to neighborhood advantages and disadvantages experienced across childhood. METHODS AND RESULTS: One hundred thirty-one boys (52.7% Black or bi/multiracial) born into low-income households in an urban environment were followed throughout childhood and completed a health assessment in adulthood. Childhood family income and home addresses were collected when participants were ages 1.5 to 17 years (13 waves). Annual income was averaged across waves to calculate mean childhood family income. Addresses were geocoded and linked with Census data to estimate neighborhood socioeconomic advantage and disadvantage at the Census-tract level and averaged across waves to estimate cumulative childhood neighborhood advantage and disadvantage. At age 32 years, participants underwent a physiological assessment, and CVH was estimated using Life's Essential 8 metrics: body mass index, blood pressure, cholesterol, glycated hemoglobin, sleep, smoking, and physical activity (diet not available). The Hayes' MEDCURVE macro was used to estimate indirect effects of childhood family income on adult CVH through neighborhood socioeconomic advantage and disadvantage across childhood. Higher childhood family income was associated with better CVH among men through greater exposure to childhood neighborhood advantage. Greater childhood family income was also protective for men's CVH through reduced exposure to childhood neighborhood disadvantage; however, the indirect effect through neighborhood disadvantage varied by childhood income and was the most robust among men raised in relatively higher-income households throughout childhood. CONCLUSIONS: Improving socioeconomic neighborhood conditions may have the potential to benefit adult CVH among racially diverse boys born into low-income urban environments.