Lennartsson Carin, Eyjólfsdóttir Harpa Sif, Celeste Roger Keller, Fritzell Johan
Aging Research Center, Karolinska Institutet & Stockholm University, Gävlegatan 16 SE-11330 Stockholm, Sweden.
Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
SSM Popul Health. 2017 Dec 21;4:169-177. doi: 10.1016/j.ssmph.2017.12.001. eCollection 2018 Apr.
In an aging society, it is important to promote the compression of poor health. To do so, we need to know more about how life-course trajectories influence late-life health and health inequalities. In this study, we used a life-course perspective to examine how health and health inequalities in late-midlife and in late-life are influenced by socioeconomic position at different stages of the life course. We used a representative sample of the Swedish population born between 1925 and 1934 derived from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) to investigate the impact of socioeconomic position during childhood (social class of origin) and of socioeconomic position in young adulthood (social class of entry) and late-midlife (social class of destination) on infirmity in late-midlife (age 60) and late-life (age 80). The results of structural equation modelling showed that poor social class of origin had no direct effect on late-midlife and late-life infirmity, but the overall indirect effect through chains of risks was significant. Thus, late-midlife and late-life health inequalities are the result of complex pathways through different social and material conditions that are unevenly distributed over the life course. Our findings suggest that policies that break the chain of disadvantage may help reduce health inequalities in late-midlife and in late-life.
在老龄化社会中，促进不良健康状况的压缩至关重要。为此，我们需要更多地了解生命历程轨迹如何影响晚年健康和健康不平等。在本研究中，我们运用生命历程视角来考察中年后期和晚年的健康及健康不平等是如何受到生命历程不同阶段社会经济地位的影响。我们使用了来自瑞典生活水平调查（LNU）和瑞典最年长者生活条件面板研究（SWEOLD）的1925年至1934年出生的瑞典人口代表性样本，来研究童年时期的社会经济地位（出身社会阶层）、青年时期的社会经济地位（进入社会阶层）和中年后期的社会经济地位（目标社会阶层）对中年后期（60岁）和晚年（80岁）体弱的影响。结构方程模型的结果表明，出身社会阶层不佳对中年后期和晚年体弱没有直接影响，但通过风险链产生的总体间接影响是显著的。因此，中年后期和晚年的健康不平等是通过不同社会和物质条件的复杂路径造成的，这些条件在生命历程中分布不均。我们的研究结果表明，打破劣势链的政策可能有助于减少中年后期和晚年的健康不平等。
