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生命历程对中国老年人健康的影响:童年期健康暴露及成年期社会经济中介因素

Life course influences on later life health in China: Childhood health exposure and socioeconomic mediators during adulthood.

作者信息

Kendig Hal, Gong Cathy Honge, Yiengprugsawan Vasoontara, Silverstein Merril, Nazroo James

机构信息

Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Australia.

ARC Centre of Excellence in Population Ageing Research, Australia.

出版信息

SSM Popul Health. 2017 Oct 7;3:795-802. doi: 10.1016/j.ssmph.2017.10.001. eCollection 2017 Dec.

Abstract

China's unprecedented population aging and social and economic change raise important issues concerning life course determinants of advantage or disadvantage into later life. Data from the China Health and Retirement Longitudinal Study (CHARLS) 2013 were analysed to identify the influence of childhood health on later life health as indicated by self-rated health and how this influence could be mediated by social and economic positions (SEP) and resources later in the life span. CHARLS provides nationally representative data on 18, 000 individuals aged 45 years and above in approximately 150 districts and 450 villages. Both multivariate logit regression model and KHB method (Karlson/Holm/Breen method) were applied to examine and decompose the life span influences on later life health. The results show that the childhood health, accounts for approximately half of the effect directly and another half of the effect indirectly through social and economic variations during adulthood. Relative living standard, marital status and urban residence are the most significant and important social and economic mediators for men; For women, living standard and secondary schooling are most influential while marital status is not significant. Implications for social and economic policies to improve later life health are discussed.

摘要

中国前所未有的人口老龄化以及社会经济变革引发了有关人生轨迹中决定老年时优势或劣势因素的重要问题。分析了中国健康与养老追踪调查(CHARLS)2013年的数据,以确定童年健康对自评健康所反映的晚年健康的影响,以及这种影响在生命周期后期如何通过社会经济地位(SEP)和资源来调节。CHARLS提供了全国代表性数据,涉及约150个县和450个村庄的18000名45岁及以上的个体。运用多元逻辑回归模型和KHB方法(卡尔森/霍尔姆/布林方法)来检验和分解生命周期对晚年健康的影响。结果表明,童年健康直接影响约占一半,另一半则通过成年期的社会经济差异间接影响。相对生活水平、婚姻状况和城市居住身份对男性来说是最重要的社会经济调节因素;对女性而言,生活水平和中等教育最具影响力,而婚姻状况则不显著。文中还讨论了改善晚年健康的社会经济政策的意义。

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