School of Public Health, University of Alberta, Edmonton, Alberta, Canada T6G 2G3.
J Health Econ. 2012 Jan;31(1):207-18. doi: 10.1016/j.jhealeco.2011.10.002. Epub 2011 Nov 6.
To date, only a few studies have assessed determinants of health trajectories using longitudinal health survey data. Multilevel models were used to estimate health-related quality of life trajectories and assess factors associated with variations among trajectories, controlling for mortality effects and cohort membership. Four biennial cycles (1996/97-2004/05) of the Canadian National Population Health Survey were used. Information for 13,665 respondents, including those who were subsequently institutionalized and/or died, was used. A typical life-course trajectory was concave with a slow decline until the age of 60, followed by a more rapid decline. Receiving social assistance, lower education and not being married had significant negative impacts on trajectories for young (age 18-39) and middle-aged (40-64). Chronic conditions and health behaviours such as smoking were important for seniors (65+). It is important to focus on the most relevant and important determinants of health in each phase of life.
迄今为止，只有少数研究使用纵向健康调查数据来评估健康轨迹的决定因素。本研究采用多水平模型来估计与健康相关的生活质量轨迹，并评估与轨迹差异相关的因素，同时控制死亡率和队列成员的影响。本研究使用了加拿大国家人口健康调查的四个两年期周期（1996/97-2004/05）。研究使用了包括随后被收容和/或死亡的 13665 名受访者的信息。典型的生命轨迹是凹形的，在 60 岁之前缓慢下降，然后下降速度更快。接受社会援助、教育程度较低和未婚对年轻（18-39 岁）和中年（40-64 岁）人群的轨迹有显著的负面影响。慢性病和吸烟等健康行为对老年人（65 岁以上）很重要。重要的是要关注生命每个阶段最相关和最重要的健康决定因素。
