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社会经济地位与生命历程中健康和疾病的生物学风险。

Socioeconomic Status and Biological Risks for Health and Illness Across the Life Course.

机构信息

Department of Sociology, University of North Carolina at Chapel Hill, Salem, Virginia.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Salem, Virginia.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2020 Feb 14;75(3):613-624. doi: 10.1093/geronb/gby108.

Abstract

OBJECTIVES

We assess the temporal properties and biosocial mechanisms underlying the associations between early-life socioeconomic status (SES) and later health. Using a life-course design spanning adolescence to older adulthood, we assess how early life and various dimensions of adult SES are associated with immune and metabolic function in different life stages and examine possible bio-behavioral and psychosocial mechanisms underlying these associations.

METHOD

Data for this study come from 3 national studies that collectively cover multiple stages of the life course (Add Health, MIDUS, and HRS). We estimated generalized linear models to examine the prospective associations between early-life SES, adult SES, and biomarkers of chronic inflammation and metabolic disorder assessed at follow-up. We further conducted formal tests of mediation to assess the role of adult SES in linking early SES to biological functions.

RESULTS

We found that early-life SES exerted consistent protective effects for metabolic disorder across the life span, but waned with time for CRP. The protective effect of respondent education remained persistent for CRP but declined with age for metabolic disorder. Adult income and assets primarily protected respondents against physiological dysregulation in middle and old ages, but not in early adulthood.

DISCUSSION

These findings are the first to elucidate the life-course patterns of SES that matter for underlying physiological functioning during the aging process to produce social gradients in health.

摘要

目的

我们评估了早期社会经济地位 (SES) 与后期健康之间关联的时间特性和生物社会机制。使用跨越青春期到老年期的生命历程设计,我们评估了早期生活和成人 SES 的各个维度如何与不同生命阶段的免疫和代谢功能相关联,并探讨了这些关联背后可能存在的生物行为和心理社会机制。

方法

本研究的数据来自于三项涵盖生命历程多个阶段的全国性研究(Add Health、MIDUS 和 HRS)。我们估计了广义线性模型,以检验早期 SES、成人 SES 与在随访中评估的慢性炎症和代谢紊乱生物标志物之间的前瞻性关联。我们进一步进行了中介作用的正式检验,以评估成人 SES 在将早期 SES 与生物功能联系起来的作用。

结果

我们发现,早期 SES 对整个生命过程中的代谢紊乱具有持续的保护作用,但 CRP 的保护作用随时间减弱。受访者教育的保护作用对 CRP 仍然持续,但对代谢紊乱则随年龄增长而下降。成人收入和资产主要保护受访者免受中年和老年时期的生理失调,但对青年时期则不然。

讨论

这些发现首次阐明了 SES 的生命历程模式,这些模式对衰老过程中潜在的生理功能很重要,从而导致健康方面的社会梯度。

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