Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA.
Soc Sci Med. 2011 Aug;73(3):391-8. doi: 10.1016/j.socscimed.2011.06.005. Epub 2011 Jun 28.
Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual's investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.-perceived chances of living to middle age and perceived chances of attending college-are associated with an individual's engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health.
青少年时期的健康相关行为为肥胖和慢性退行性疾病的风险建立了轨迹，它们代表了社会经济环境塑造发病率和死亡率模式的重要途径。大多数促进健康的行为都需要做出选择，这些选择可能要到未来才能得到回报，但预测个人对未来健康投资的因素尚不清楚。在本文中，我们考虑了在美国与青少年相关的两个领域的未来期望——活到中年的机会和上大学的机会——是否与个人从事长期保护健康的行为有关。我们关注青春期，因为这是一个重要的人生阶段，在此期间形成的习惯可能会影响以后的疾病风险轨迹。我们使用来自美国青少年的大型全国代表性样本（美国青少年纵向研究）的数据，来预测年轻人在成年期的体育活动、快餐消费和吸烟水平与青春期的生活机会之间的关系，同时控制基线健康行为和广泛的潜在混杂因素。我们发现，认为自己上大学机会较高的青少年在成年后更频繁地锻炼，吸烟也较少。对活到 35 岁的期望较高的青少年在成年后吸烟较少。父母的教育程度是生活机会感知和健康行为的重要预测因素，但对于每种结果，生活机会感知的影响都是独立于、而且往往强于父母教育程度的。因此，青少年时期的生活机会感知可能在建立个人健康轨迹和导致人口健康的社会梯度方面发挥重要作用。
