Dr. Zorba Paster: Childhood friendships can impact health later in life

Stress, psychological stress, can be a big determiner of health. Most of you know it. You’ve felt it. You’ve been through stressful times before and wondered how that might affect your life.

No one, and I mean no one, gets through life without stress. Just look at the stress that COVID-19 has caused all of us.

These days, we can’t go out with our friends, go to a show, movie or football game or even hug our children or loved ones at a wedding or funeral. I call that mega stress.

But what happens when you have stress in your childhood – stress among kids who are too young to read my column?

Middle school and high school are stressful to lots of kids. How that affects their future lives is a biggie.

Does peer status when you’re young determine your health when you’re older? And, if so, how can you change it?

There are numerous studies showing that childhood conditions affect later life – from health inequality and home life to how much food you get and immunizations.

Mental health, physical health, metabolic diseases, risk of depression, suicide and murder rates, alcoholism and opioid addiction are all affected by where a kid lives, who they live with, their opportunities and home life.

We know parental socioeconomic conditions are a key factor. What we don’t know as well is how peer conditions at school and home play a role.

For that, let’s look at a recent article published in the British Medical Journal. This was a study from Sweden, where the government knows much more when it comes to health. They have stellar statistics, which means the data is stronger.

They looked at people born in 1953 in Stockholm. Now, keep in mind this was a stressful time for Swedes. World War II was recently over. Conditions involving food, money and opportunity were not nearly as great as they are now. The nation was recovering, just as the rest of Europe and elsewhere, from a worldwide calamity.

Researchers focused on a sample of 5,500 boys and 6,000 girls who had been tested for health, grades in school and social status (more on how they measured social status later). Peer status was measured when these boys and girls were 13 years old. You remember 13, don’t you?

“Unpopular” 13-year-olds were more likely to develop circulatory system disease. That included conditions affecting the normal functioning of the heart and blood vessels, such as hardening of the arteries, and abnormal heart rhythms, such as atrial fibrillation.

We know that childhood family circumstances and living conditions are important predictors of subsequent mental and physical health. But it’s not entirely clear what impact peer group status might have.

So how did they measure peer status? These 13-year-olds back in the 1950s were asked who they would like to work with, and there were four categories.

If a kid in the class got zero nominations, they were considered to be marginalized. One nomination made them low status, two or three made them medium status, and four or more made them high status.

Information also was obtained on family factors, such as number and position of siblings; parental education and mental health; socioeconomic conditions; and school factors such as intellect, academic performance and any criminal behavior.

Slightly more of the boys enjoyed high peer group status at age 13 – 33%, or 1,800 boys – than did girls, with 29% or 1,700 of them rating in the high peer group. And more of the girls were marginalized – 16%, or 940 girls vs. 12% or 652 boys.

Fast forward to adulthood. Turns out, if a kid’s peers didn’t want to work with them at 13, they were 33% more likely to have circulatory problems.

We know that family and school factors, income, etc., influence mental and physical health, but where does something like this fit in? The fact is, we have very little data about how childhood position in the pecking order influences outcomes as adults.

My spin: Peer relations play an important role for children’s emotional and social development and may have considerable long-term implications on their health.

As researchers in this study said, “There is convincing evidence from neuroscience regarding how social relationships modulate neuroendocrine responses that subsequently affect the circulatory system, increasing the risk for stroke and cardiovascular diseases.”

Now, one caveat here: This doesn’t mean that how you are at 13 determines what you’re health will be like at 50. But it does show that early childhood social relationships play a key role.

It also suggests that, as a parent, if your child is “on the outs” with peers, you might want to consider how those circumstances could be changed. It just might help. Stay well.

Dr. Zorba Paster is a family physician and host of the public radio program “Zorba Paster on Your Health.” He can be reached at askzorba@doctorzorba.com.