Gustafsson Per E, San Sebastian Miguel
Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
PLoS One. 2014 Jun 12;9(6):e99558. doi: 10.1371/journal.pone.0099558. eCollection 2014.
A large body of research has shown that health is influenced by disadvantaged living conditions, including both personal and neighborhood conditions. Little is however known to what degree the health impact of different forms of disadvantage differ along the life course. The present study aims to examine when, during the life course, neighborhood and individual disadvantages relate to functional somatic symptoms. Participants (n = 992) came from The Northern Swedish Cohort and followed from age 16, 21, 30 until 42 years. Functional somatic symptoms, socioeconomic disadvantage, and social and material adversity were measured through questionnaires and linked to register data on neighborhood disadvantage. Data was analyzed with longitudinal and cross-sectional multilevel models. Results showed that neighborhood disadvantage, social and material adversity and gender all contributed independently to overall levels of symptoms across the life course. Cross-sectional analyses also suggested that the impact of disadvantage differed between life course periods; neighborhood disadvantage was most important in young adulthood, and the relative importance of material versus social adversity increased as participants grew older. In summary, the study suggests that disadvantages from different contextual sources may affect functional somatic health across the life course, but also through life course specific patterns.
大量研究表明,健康受到不利生活条件的影响,包括个人条件和社区环境。然而,对于不同形式的不利条件对健康的影响在生命历程中会有多大差异,我们却知之甚少。本研究旨在探讨在生命历程的哪个阶段,社区不利条件和个人不利条件与功能性躯体症状相关。参与者(n = 992)来自瑞典北部队列,从16岁、21岁、30岁一直追踪到42岁。通过问卷调查测量功能性躯体症状、社会经济不利条件以及社会和物质逆境,并将其与社区不利条件的登记数据相联系。采用纵向和横断面多层次模型对数据进行分析。结果显示,社区不利条件、社会和物质逆境以及性别在整个生命历程中都对症状的总体水平有独立影响。横断面分析还表明,不利条件的影响在生命历程的不同阶段有所不同;社区不利条件在青年期最为重要,随着参与者年龄增长,物质逆境与社会逆境的相对重要性增加。总之,该研究表明,来自不同背景来源的不利条件可能在整个生命历程中影响功能性躯体健康,而且还通过特定于生命历程的模式产生影响。