Abstract Body (Do not enter title and authors here): Background: Socioeconomic status (SES) is associated with worse cardiovascular health (CVH) and poorer health outcomes. Stable, full-time employment is one protective SES factor among adults. However, it is unclear how employment among adults may influence long-term health among children. We explored the association of county-level labor force participation during childhood and CVH among these children when they were young adults.

Research Question: Is county-level labor force participation during childhood associated with CVH in young adulthood?

Methods: We analyzed data from Future of Families and Child Wellbeing Study, a birth cohort with county-level measures of labor force participation at time of birth (1998-2000, measured as county-level proportion of people aged ≥16 years that are in the labor force, for a child’s county of residence) and CVH measured at study year 22. Multivariable linear regression models evaluated the associations between county-level labor force participation in childhood (low [z-score ≤-0.5], intermediate [z-score -0.5 to 0.5], and high [z-score ≥0.5]) and CVH factors in young adulthood (systolic blood pressure [SBP], non-HDL cholesterol (non-HDL-C), hemoglobin A1c, body mass index (BMI)] and Life’s Essential 8 (LE8) CVH scores at year 22, adjusting for child’s sex, family income in childhood, primary caregiver’s educational attainment, mother’s age at baseline.

Results: Of 1,183 participants, 54% were female, 52% were Black, 26% were Hispanic, and 17% were White. The range of county-level labor force participation was: low, 42.0%-61.2%; intermediate, 61.6%-66.0%; high, 66.3%-75.5%. Compared to living in a county with high labor force participation during childhood (Table 1), living in a county with intermediate labor force participation was significantly associated with a 3.7-point higher non-HDL-C LE8 score (95% CI 0.38, 7.0) and a 1.7 mmHg lower systolic BP (95% CI -3.2, -0.09)) in young adulthood. Living in a county with low labor force participation was associated with a 2.4-point lower LE8 glucose score (95% CI -4.5,-0.02), a 8.3-point lower LE8 physical activity score (95% CI -15.0, -1.4), and a 5.3 mg/dL lower non-HDL-C (95% CI -10.0, -0.30) in young adulthood.

Conclusions: Living in a county with low or intermediate (versus high) labor force participation during childhood was associated with worse CVH factors in young adulthood. Socioeconomic environment during childhood may contribute to CVH later in life.