Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Switzerland.
Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland.
J Gerontol B Psychol Sci Soc Sci. 2020 Jun 2;75(6):1312-1325. doi: 10.1093/geronb/gbaa036.
This study aimed to examine the cumulative disadvantage of different forms of childhood misfortune and adult-life socioeconomic conditions (SEC) with regard to trajectories and levels of self-rated health in old age and whether these associations differed between welfare regimes (Scandinavian, Bismarckian, Southern European, and Eastern European).
The study included 24,004 respondents aged 50-96 from the longitudinal SHARE survey. Childhood misfortune included childhood SEC, adverse childhood experiences, and adverse childhood health experiences. Adult-life SEC consisted of education, main occupational position, and financial strain. We analyzed associations with poor self-rated health using confounder-adjusted mixed-effects logistic regression models for the complete sample and stratified by welfare regime.
Disadvantaged respondents in terms of childhood misfortune and adult-life SEC had a higher risk of poor self-rated health at age 50. However, differences narrowed with aging between adverse-childhood-health-experiences categories (driven by Southern and Eastern European welfare regimes), categories of education (driven by Bismarckian welfare regime), and main occupational position (driven by Scandinavian welfare regime).
Our research did not find evidence of cumulative disadvantage with aging in the studied life-course characteristics and age range. Instead, trajectories showed narrowing differences with differing patterns across welfare regimes.
本研究旨在考察不同形式的童年不幸和成年后社会经济状况(SEC)与老年自评健康轨迹和水平的累积劣势,以及这些关联在福利制度(斯堪的纳维亚、俾斯麦、南欧和东欧)之间是否存在差异。
本研究纳入了来自纵向 SHARE 调查的 24004 名 50-96 岁的受访者。童年不幸包括童年 SEC、不良童年经历和不良童年健康经历。成年后 SEC 包括教育、主要职业地位和经济压力。我们使用混杂效应逻辑回归模型,在全样本中进行分析,并根据福利制度进行分层,以评估与自评健康不良的关联。
在童年不幸和成年后 SEC 方面处于劣势的受访者在 50 岁时自评健康不良的风险更高。然而,随着年龄的增长,不同的童年健康经历类别(受南欧和东欧福利制度驱动)、教育类别(受俾斯麦福利制度驱动)和主要职业地位(受斯堪的纳维亚福利制度驱动)之间的差异逐渐缩小。
我们的研究没有发现研究生命历程特征和年龄范围内存在与年龄相关的累积劣势的证据。相反,轨迹显示出不同福利制度之间存在差异缩小的模式。