Chen Edith, Martin Andrew D, Matthews Karen A
Department of Psychology, University of British Columbia, 2136 W Mall, Vancouver, British Columbia, Canada V6T 1Z4.
Pediatrics. 2007 Aug;120(2):e297-303. doi: 10.1542/peds.2006-3098. Epub 2007 Jul 2.
Socioeconomic status is one of the most robust social factors associated with health, but the dynamics of how socioeconomic status over time affects children's health remains unclear. This study tested how various models of childhood socioeconomic status (accumulation, change, variability, and critical periods of family income) would predict health outcomes at a final time point in childhood.
This was a prospective, longitudinal study of 6306 children who were aged 10 to 11 years and whose families were interviewed every other year from birth onward. The sample came from the US National Longitudinal Survey of Youth-Children. In the same data set, a replication sample of 4305 14- to 15-year-old children was also examined. Primary outcomes included parent report of asthma and conditions that limited activity and school and required physician treatment.
Lower cumulative family income was associated with higher odds for having a condition that limited childhood activities, as well as a condition that required treatment by a physician at ages 10 to 11. Cumulative family income was a stronger predictor than change in income or variability in income. Lower family income early in life (ages 0-5 years) was associated with higher odds for having a condition that limited activities and a condition that required treatment by a physician at ages 10 to 11, independent of current socioeconomic status. Findings were replicated in the 14- to 15-year-old sample.
These findings suggest that the accumulation of socioeconomic status in terms of family income across childhood is more important than social mobility or variability in socioeconomic status, although there may be certain periods of time (early life) that have stronger effects on health. These findings suggest the importance of childhood interventions for reducing health disparities.
社会经济地位是与健康相关的最有力的社会因素之一，但社会经济地位随时间变化如何影响儿童健康的动态过程仍不清楚。本研究测试了儿童社会经济地位的各种模型（家庭收入的积累、变化、变异性和关键时期）如何预测儿童期最后一个时间点的健康结果。
这是一项对6306名10至11岁儿童的前瞻性纵向研究，从出生起每隔一年对其家庭进行访谈。样本来自美国全国青年纵向调查-儿童调查。在同一数据集中，还对4305名14至15岁儿童的复制样本进行了检查。主要结果包括父母报告的哮喘以及限制活动、上学并需要医生治疗的疾病。
较低的家庭累计收入与儿童期活动受限疾病以及10至11岁时需要医生治疗的疾病的较高几率相关。家庭累计收入比收入变化或收入变异性更能预测结果。生命早期（0至5岁）较低的家庭收入与10至11岁时活动受限疾病以及需要医生治疗的疾病的较高几率相关，与当前社会经济地位无关。这些发现在14至15岁的样本中得到了重复。
这些发现表明，童年时期家庭收入方面的社会经济地位积累比社会流动性或社会经济地位的变异性更重要，尽管可能有某些时期（生命早期）对健康的影响更强。这些发现表明了儿童期干预对于减少健康差距的重要性。
