Department of Family and Community Medicine, University of California, San Francisco, 550 16th Street, San Francisco CA, USA.
Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco CA, USA.
J Public Health (Oxf). 2019 Sep 30;41(3):566-574. doi: 10.1093/pubmed/fdz018.
Socioeconomically disadvantaged children have worse adult health; we test if this 'long arm' of childhood disadvantage can be overcome through upward socioeconomic mobility in adulthood.
Four SES trajectories (stable low, upwardly mobile, downwardly mobile and stable high) were created from median dichotomized childhood socioeconomic status (SES; childhood human and financial capital) and adult SES (wealth at age 67) from Health and Retirement Study respondents (N = 6669). Healthy ageing markers, in tertiles, were walking speed, peak expiratory flow (PEF), and grip strength measured in 2008 and 2010. Multinomial logistic regression models, weighted to be nationally representative, controlled for age, gender, race, birthplace, outcome year and childhood health and social capital.
Upwardly mobile individuals were as likely as the stable high SES group to be in the best health tertile for walking speed (OR = 0.81; 95% CI: 0.63, 1.05; P = 0.114), PEF (OR = 0.97; 95% CI: 0.78, 1.21; P = 0.810) and grip strength (OR = 0.97; 95%CI: 0.74, 1.27; P = 0.980).
Findings suggest the 'long arm' of childhood socioeconomic disadvantage can be overcome for these markers of healthy ageing through upward socioeconomic mobility.
社会经济地位较低的儿童成年后的健康状况较差；本研究旨在检验通过成年后向上的社会经济流动，能否克服童年时期社会经济劣势的“长期影响”。
本研究根据健康与退休研究（Health and Retirement Study）参与者的童年社会经济地位（SES；童年时期的人力和财力资本）和成年 SES（67 岁时的财富）中位数二分类情况，创建了 4 种 SES 轨迹（稳定低 SES、向上流动、向下流动和稳定高 SES）。2008 年和 2010 年，采用行走速度、呼气峰值流量（PEF）和握力的三分位数作为健康老龄化标志物，对参与者进行了测量。使用全国代表性的加权多项逻辑回归模型，控制了年龄、性别、种族、出生地、结果年份以及儿童时期的健康和社会资本。
向上流动的个体与稳定高 SES 组一样，有更高的可能性处于行走速度最佳健康三分位数（OR=0.81；95%CI：0.63，1.05；P=0.114）、PEF（OR=0.97；95%CI：0.78，1.21；P=0.810）和握力最佳健康三分位数（OR=0.97；95%CI：0.74，1.27；P=0.980）。
研究结果表明，通过向上的社会经济流动，童年时期社会经济劣势的“长期影响”可以在这些健康老龄化标志物上得到克服。
