Department of Clinical Sciences, Malmö University Hospital, Lund University, S-205 02, Malmö, Sweden.
BMC Public Health. 2012 Sep 11;12:761. doi: 10.1186/1471-2458-12-761.
Research in recent decades increasingly indicates the importance of conditions in early life for health in adulthood. Only few studies have investigated socioeconomic conditions in both childhood and adulthood in relation to health testing the risk accumulation, critical period, and social mobility hypotheses within the same setting. This study investigates the associations between economic stress in childhood and adulthood, and self-rated health with reference to the accumulation, critical period and social mobility hypotheses in life course epidemiology, taking demographic, social support, trust and lifestyle factors into account.
The public health survey in Skåne (southern Sweden) in 2008 is a cross-sectional postal questionnaire study based on a random sample, in which 28,198 persons aged 18-80 years participated (55% participation). Logistic regression models were used to investigate associations between economic stress in childhood and adulthood, and self-rated health.
Three life-course socioeconomic models concerning the association between economic stress and self-rated health (SRH) were investigated. The results showed a graded association between the combined effect of childhood and adulthood economic stress and poor SRH in accordance with the accumulation hypothesis. Furthermore, upward social mobility showed a protecting effect and downward mobility increased odds ratios of poor SRH in accordance with the social mobility hypothesis. High/severe economic stress exposures in both stages of life were independently associated with poor SRH in adulthood. Furthermore, stratifying the study population into six age groups showed similar odds ratios of poor SRH regarding economic stress exposure in childhood and adulthood in all age groups among both men and women.
The accumulation and social mobility hypotheses were confirmed. The critical period model was confirmed in the sense that both economic stress in childhood and adulthood had independent effects on poor SRH. However, it was not confirmed in the sense that a particular window in time (in childhood or adulthood) had a specifically high impact on self-rated health.
近几十年来的研究越来越多地表明，人生早期的状况对成年后的健康至关重要。只有少数研究调查了儿童期和成年期的社会经济状况与健康之间的关系，在同一背景下检验了风险积累、关键期和社会流动假说。本研究调查了儿童期和成年期经济压力与自评健康之间的关系，并参考生命历程流行病学中的积累、关键期和社会流动假说，考虑了人口统计学、社会支持、信任和生活方式因素。
2008 年在瑞典斯科讷（南部）进行的公共卫生调查是一项基于随机样本的横断面邮寄问卷研究，共有 28198 名 18-80 岁的人参与（参与率为 55%）。使用逻辑回归模型调查了儿童期和成年期经济压力与自评健康之间的关系。
研究了三种与经济压力和自评健康（SRH）相关的生命历程社会经济模型。结果表明，根据积累假说，童年和成年期经济压力的综合效应与较差的 SRH 呈梯度相关。此外，向上的社会流动显示出保护作用，而向下的流动则增加了较差的 SRH 的比值比，符合社会流动假说。一生中两个阶段的高/严重经济压力暴露与成年期较差的 SRH 独立相关。此外，将研究人群分为六个年龄组，在所有年龄组和男女两性中，童年和成年期经济压力暴露与较差的 SRH 之间的比值比相似。
积累和社会流动假说得到了证实。关键期模型得到了证实，即儿童期和成年期的经济压力都对较差的 SRH 有独立影响。然而，它并没有得到证实，即特定的时间窗口（在儿童期或成年期）对自评健康有特别高的影响。
