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芬兰一生中的社会经济地位与全因死亡率及特定病因死亡率

Socioeconomic status across the life course and all-cause and cause-specific mortality in Finland.

作者信息

Elo Irma T, Martikainen Pekka, Myrskylä Mikko

机构信息

Population Studies Center & Department of Sociology, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104, United States.

Population Research Unit, Department of Social Research, University of Helsinki, P.O. Box 18, FIN-00014 University of Helsinki, Finland.

出版信息

Soc Sci Med. 2014 Oct;119:198-206. doi: 10.1016/j.socscimed.2013.11.037. Epub 2013 Nov 28.

Abstract

We used high quality register based data to study the relationship between childhood and adult socio-demographic characteristics and all-cause and cause-specific mortality at ages 35-72 in Finland among cohorts born in 1936-1950. The analyses were based on a 10% sample of households drawn from the 1950 Finnish Census of Population with the follow-up of household members in subsequent censuses and death records beginning from the end of 1970 through the end of 2007. The strengths of these data come from the fact that neither childhood nor adult characteristics are self reported and thus are not subject to recall bias, misreporting and no loss to follow-up after age 35. In addition, the study population includes several families with at least two children enabling us to control for unobserved family characteristics. We documented significant associations between early life social and family conditions on all-cause mortality and cause-specific mortality, with protective effects of higher childhood socio-demographic characteristics varying between 10% and 30%. These associations were mostly mediated through adult educational attainment and occupation, suggesting that the indirect effects of childhood conditions were more important than their direct effects. We further found that adult socioeconomic status was a significant predictor of mortality. The associations between adult characteristics and mortality were robust to controls for observed and unobserved childhood characteristics. The results imply that long-term adverse health consequences of disadvantaged early life social circumstances may be mitigated by investments in educational and employment opportunities in early adulthood.

摘要

我们使用基于高质量登记册的数据,研究了1936年至1950年出生队列中芬兰35至72岁人群儿童期和成年期社会人口特征与全因死亡率及特定病因死亡率之间的关系。分析基于从1950年芬兰人口普查中抽取的10%家庭样本,并对后续普查中的家庭成员进行跟踪,以及从1970年底至2007年底的死亡记录。这些数据的优势在于,儿童期和成年期特征均非自我报告,因此不受回忆偏倚、误报影响,且35岁之后无失访情况。此外,研究人群包括几个至少有两个孩子的家庭,使我们能够控制未观察到的家庭特征。我们记录了早年社会和家庭状况与全因死亡率及特定病因死亡率之间的显著关联,较高的儿童期社会人口特征的保护作用在10%至30%之间变化。这些关联大多通过成人教育程度和职业介导,表明儿童期状况的间接影响比直接影响更重要。我们进一步发现,成年社会经济地位是死亡率的重要预测因素。成年特征与死亡率之间的关联在控制观察到的和未观察到的儿童期特征后依然稳健。结果表明,通过在成年早期投资教育和就业机会,可减轻早年社会处境不利带来的长期不良健康后果。

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