Lam Jack, O'Flaherty Martin, Baxter Janeen
Institute for Social Science Research, Life Course Centre - University of Queensland, Australia.
SSM Popul Health. 2019 Jan 15;7:100354. doi: 10.1016/j.ssmph.2019.100354. eCollection 2019 Apr.
This study estimates multilevel mixed effects models of three retrospective measures of childhood health - self-rated childhood health, exposure to parental smoking growing up, and missing school for 30 or more consecutive days due to a health event - on levels and changes in physical functioning at age 50 and beyond. Using data from 15 waves of the Household, Income and Labour Dynamics in Australia survey, the results show that variation in the level of later-life physical functioning is associated with childhood health. Poor childhood health however is not associated with the rate of physical functioning decline. Respondents who reported poor childhood health and were migrants to Australia from a non-English speaking country reported better physical functioning in later life, compared with non-Indigenous Australian-born respondents who reported poor childhood health. In contrast, women who reported poor self-rated childhood health reported worse physical functioning compared with men who reported poor self-rated childhood health. These findings are robust to the inclusion of a range of measures of childhood and adult characteristics and circumstances. These results suggest that Australia, with arguably a strong and supportive health care system as compared with the U.S., may mitigate the accumulation of disadvantages to those who reported poor childhood health. We note that though functional health differences due to childhood health are not exacerbated in later life, neither are they eliminated.
本研究估计了儿童健康的三项回顾性指标——儿童自我评定健康状况、成长过程中接触父母吸烟情况以及因健康事件连续缺课30天及以上——对50岁及以上人群身体机能水平和变化的多层次混合效应模型。利用澳大利亚家庭、收入与劳动力动态调查15个波次的数据,结果显示,晚年身体机能水平的差异与儿童健康状况有关。然而,儿童健康状况不佳与身体机能下降的速率无关。报告童年健康状况不佳且从非英语国家移民到澳大利亚的受访者,与报告童年健康状况不佳的澳大利亚本土非原住民受访者相比,晚年身体机能更好。相比之下,报告童年自我评定健康状况不佳的女性,与报告童年自我评定健康状况不佳的男性相比,身体机能更差。这些发现对于纳入一系列儿童和成人特征及情况的衡量指标具有稳健性。这些结果表明,与美国相比,澳大利亚的医疗保健系统可能更强大且更具支持性,这可能会减轻童年健康状况不佳者的不利因素积累。我们注意到,尽管童年健康导致的功能健康差异在晚年并未加剧,但也没有消除。