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中国高龄老人童年社会经济状况与健康长寿的关联

The association of childhood socioeconomic conditions with healthy longevity at the oldest-old ages in China.

作者信息

Yi Zeng, Gu Danan, Land Kenneth C

机构信息

Center for Study of Aging and Human Development, Duke University, Durham, NC 27710, USA.

出版信息

Demography. 2007 Aug;44(3):497-518. doi: 10.1353/dem.2007.0033.

Abstract

Based on unique data from the largest-ever sample of the Chinese oldest-old aged 80 and older, our multivariate logistic regression analyses show that either receiving adequate medical service during sickness in childhood or never/rarely suffering from serious illness during childhood significantly reduces the risk of being ADL (activities of daily living) impaired, being cognitively impaired, and self-reporting poor health by 18%-33% at the oldest-old ages. Estimates of effects for five other indicators of childhood conditions are similarly positive but mostly not statistically significant. Multivariate survival analysis shows that better childhood socioeconomic conditions in general tend to reduce the four-year period mortality risk among the oldest-old. But after additional controls for 14 covariates are put into the model, the effects are not statistically significant, thus suggesting that most of the effects of childhood conditions on oldest-old mortality are indirect-at least to the point of affecting current health status at the oldest-old ages, which itself is strongly associated with mortality. While acknowledging limitations of the present analyses due to a lack of information on childhood illness, the oldest-olds'recollection errors, and other data problems, we conclude, based on this and other studies, that policies that enhance childhood health care and children's socioeconomic well-being can have large and long-lasting benefits up to the oldest-old ages.

摘要

基于有史以来规模最大的80岁及以上中国高龄老人样本的独特数据,我们的多变量逻辑回归分析表明,童年时期生病时获得充分医疗服务,或童年时期从未/很少患重病,均可显著降低高龄老人日常生活活动(ADL)受损、认知受损和自我报告健康状况不佳的风险,降幅达18%-33%。童年状况的其他五项指标的影响估计同样呈正向,但大多无统计学意义。多变量生存分析表明,总体而言,童年时期较好的社会经济状况往往会降低高龄老人四年期死亡风险。但在模型中额外纳入14个协变量进行控制后,这些影响无统计学意义,这表明童年状况对高龄老人死亡率的大多数影响是间接的——至少在影响高龄老人当前健康状况这一点上是如此,而当前健康状况本身与死亡率密切相关。尽管认识到由于缺乏童年疾病信息、高龄老人回忆误差及其他数据问题,本分析存在局限性,但基于此项研究及其他研究,我们得出结论,加强儿童期医疗保健和儿童社会经济福祉的政策,可在高龄阶段带来巨大且持久的益处。

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