Osler Merete, Andersen Anne-Marie Nybo, Lund Rikke, Holstein Bjørn
Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark.
Eur J Public Health. 2005 Dec;15(6):647-51. doi: 10.1093/eurpub/cki066. Epub 2005 Aug 10.
The adverse effect on health of poor social circumstances might accumulate not only over the lifespan of the individual but also across generations. This study examines the effect of parent's and grandparent's socioeconomic position on all-cause mortality of their adult offspring.
2890 males born in the metropolitan area of Copenhagen, Denmark in 1953, whose mothers were interviewed for information on family social background in 1968, were followed from 1968 to 2002 for information on vital status by record linkage to the Civil Registration System. The data were analysed using Cox regression models.
All-cause mortality from age 15 to 49 years increased 25% [95% confidence interval (CI) 13-39%] for each number of parents or grandparents from working or unknown occupational social class. Offspring mortality decreased with the number of ancestors with a secondary school education hazard ratio [HR = 0.84 (95% CI 0.76-0.93)]. When the cumulative measures of ancestor's occupation and education were included in the same model, the estimates for the effect of occupational social class [HR = 1.19 (95% CI 1.06-1.34)] and education [HR = 0.91 (95% CI 0.80-1.03)] both attenuated. These relations only changed slightly when subject's own occupational class at age 22 years was taken into account.
The adverse health effects of disadvantaged social circumstances accumulate not only over an individual's lifespan but also across generations. Cumulated occupational social class of ancestors seems to be an independent predictor of mortality in adult life after adjustment for subject's own social class at age 22 years.
恶劣的社会环境对健康产生的不利影响可能不仅会在个体的一生中不断累积，还会在代际间累积。本研究考察了父母及祖父母的社会经济地位对其成年子女全因死亡率的影响。
选取了1953年出生在丹麦哥本哈根大都市区的2890名男性，他们的母亲在1968年接受了访谈，以获取家庭社会背景信息。从1968年至2002年，通过与民事登记系统的记录链接，追踪这些男性的生命状况信息。数据采用Cox回归模型进行分析。
对于父母或祖父母处于工作或职业社会阶层不明的每增加一人，15至49岁的全因死亡率就会增加25%[95%置信区间（CI）13 - 39%]。随着具有中学教育水平的祖先人数增加，后代死亡率降低，风险比[HR = 0.84（95%CI 0.76 - 0.93）]。当将祖先职业和教育的累积指标纳入同一模型时，职业社会阶层[HR = 1.19（95%CI 1.06 - 1.34）]和教育[HR = 0.91（95%CI 0.80 - 1.03）]的影响估计值均有所减弱。当考虑到受试者22岁时自身的职业阶层时，这些关系仅有轻微变化。
不利的社会环境对健康产生的不良影响不仅会在个体一生中累积，还会在代际间累积。在对受试者22岁时自身的社会阶层进行调整后，祖先的累积职业社会阶层似乎是成年后死亡率的一个独立预测因素。
