Kahn Robert S, Wilson Kathryn, Wise Paul H
Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 4522-3039, USA.
Public Health Rep. 2005 Jul-Aug;120(4):399-408. doi: 10.1177/003335490512000407.
Relatively little is known about the intergenerational mechanisms that lead to social disparities in child health. We examined whether the association between low socioeconomic status (SES) and child behavior problems is mediated by maternal health conditions and behavior.
Prospective cohort data (1979-1998) on 2,677 children and their mothers were obtained from the National Longitudinal Survey of Youth. SES, the Child Behavior Problems Index (BPI), and maternal smoking, depressive symptoms, and alcohol use before, during, and after pregnancy were examined.
Lower income and lower maternal education were associated with increased child BPI scores. Adjustment for maternal smoking, depressive symptoms, and alcohol use attenuated the associations between SES and child BPI by 26% to 49%. These maternal health conditions often occurred together, persisted over time, and were associated with the mother's own childhood SES and pre-pregnancy health.
Social disparities in women's health conditions may help shape the likelihood of behavior problems in the subsequent generation. Improved public health programs and services for disadvantaged women across the lifecourse may not only address their own urgent health needs, but reduce social disparities in the health and well-being of their children.
关于导致儿童健康方面社会差异的代际机制，我们了解得相对较少。我们研究了低社会经济地位（SES）与儿童行为问题之间的关联是否由母亲的健康状况和行为介导。
从全国青年纵向调查中获取了2677名儿童及其母亲的前瞻性队列数据（1979 - 1998年）。研究了SES、儿童行为问题指数（BPI）以及母亲在怀孕前、孕期和产后的吸烟、抑郁症状和饮酒情况。
较低的收入和较低的母亲教育程度与儿童BPI得分升高相关。对母亲吸烟、抑郁症状和饮酒情况进行调整后，SES与儿童BPI之间的关联减弱了26%至49%。这些母亲的健康状况常常同时出现，随时间持续存在，并且与母亲自身童年的SES和孕前健康状况相关。
女性健康状况方面的社会差异可能有助于塑造下一代出现行为问题的可能性。在整个生命历程中，为弱势女性改善公共卫生项目和服务，不仅可以满足她们自身紧迫的健康需求，还能减少其子女在健康和幸福方面的社会差异。
