Lund Rikke, Christensen Ulla, Holstein Bjørn Evald, Due Pernille, Osler Merete
Department of Social Medicine, Institute of Public Health, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen N, Denmark.
J Epidemiol Community Health. 2006 Jun;60(6):496-501. doi: 10.1136/jech.2005.037689.
This study examined the effects of marital status over two and three generations on last generation's mortality, and tested the hypothesis of an effect of the latest status (proximity effect) as well as the hypothesis of an accumulative effect.
The study population covers a random sample of all boys born in the the metropolitan area of Copenhagen with complete data from interviews and registers on two and three generation's marital status, socioeconomic position variables, and last generation's admission to psychiatric hospital, n = 2614. Among these 105 deaths occurred. Cox proportional hazards regression models were used to estimate the effect of marital status on mortality.
Never married sons showed a considerably increased mortality compared with their married counterparts in the adjusted analyses. Mother's marital status at childbirth was also associated with increased mortality among the sons. There was no independent effect of maternal grandparent's experience of divorce on third generation's mortality. Son's marital status was the strongest marital status predictor of mortality. Accumulation of both two and three generations' marital status was significantly associated with mortality risk in a dose-response pattern. All analyses were adjusted for socioeconomic position variables and mental health.
These results support the proximity hypothesis as son's marital status was the strongest predictor of mortality, and suggest an accumulative effect as each of the three non-married generations added to an increased mortality risk.
本研究考察了两代和三代婚姻状况对上一代人死亡率的影响,并检验了最近婚姻状况的影响(近因效应)假说以及累积效应假说。
研究人群为哥本哈根大都市区出生的所有男孩的随机样本,有来自访谈和登记处的关于两代和三代婚姻状况、社会经济地位变量以及上一代人入住精神病院的完整数据,样本量n = 2614。其中有105人死亡。采用Cox比例风险回归模型来估计婚姻状况对死亡率的影响。
在调整分析中,从未结婚的儿子与已婚儿子相比死亡率显著增加。母亲分娩时的婚姻状况也与儿子死亡率增加有关。外祖母离婚经历对第三代死亡率没有独立影响。儿子的婚姻状况是死亡率最强的婚姻状况预测因素。两代和三代婚姻状况的累积与死亡率风险呈剂量反应模式显著相关。所有分析均对社会经济地位变量和心理健康进行了调整。
这些结果支持近因假说,因为儿子的婚姻状况是死亡率最强的预测因素,并表明存在累积效应,因为三代未婚人群中的每一代都会增加死亡风险。