Gondek Dawid, Ploubidis George B, Hossin Muhammad Zakir, Gao Menghan, Bann David, Koupil Ilona
Centre for Longitudinal Studies, UCL Institute of Education, University College London, United Kingdom.
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
SSM Popul Health. 2021 Jan 21;13:100741. doi: 10.1016/j.ssmph.2021.100741. eCollection 2021 Mar.
We aimed to investigate cohort differences in age trajectories of hospitalization due to non-communicable conditions, and if these varied by paternal socioeconomic position. We used the Uppsala Birth Cohort Multigenerational Study-including virtually complete information on medical diagnoses. Our sample constituted 28,448 individuals (103,262 observations). The outcome was five-year prevalence of hospitalization due to major non-communicable conditions in 1989-2008. The exposures were age (19-91), year-of-birth (1915-1929; 1938-1972), gender (man vs woman), and parental socioeconomic position (low, medium, and high). We used multilevel logit models to examine associations between exposures and the hospitalization outcome. Younger cohorts had a higher prevalence of hospitalization at overlapping ages than those born earlier, with inter-cohort differences emerging from early-adulthood and increasing with age. For instance, at age 40 predicted probability of hospitalization increased across birth-cohorts-from 1.2% (born in 1948-52) to 2.0% (born in 1963-67)-whereas at age 50 it was 2.9% for those born in 1938-42 compared with 4.6% among participants born in 1953-57. Those with medium and low socioeconomic position had 13.0% and 20.0% higher odds of experiencing hospitalization during the observation period, respectively-when age, year-of-birth and gender were accounted for. We found that no progress was made in reducing the socioeconomic inequalities in hospitalization across cohorts born between 1915 and 1972. Hence, more effective policies and interventions are needed to reduce the overall burden of morbidity-particularly among the most vulnerable.
我们旨在研究非传染性疾病导致的住院年龄轨迹的队列差异，以及这些差异是否因父亲的社会经济地位而异。我们使用了乌普萨拉出生队列多代研究，其中包括几乎完整的医学诊断信息。我们的样本包括28448名个体（103262次观察）。研究结果是1989年至2008年因主要非传染性疾病住院的五年患病率。暴露因素包括年龄（19至91岁）、出生年份（1915年至1929年；1938年至1972年）、性别（男性与女性）以及父母的社会经济地位（低、中、高）。我们使用多水平logit模型来检验暴露因素与住院结果之间的关联。较年轻的队列在重叠年龄的住院患病率高于较早出生的队列，队列间差异从成年早期开始出现，并随年龄增长而增加。例如，在40岁时，不同出生队列的住院预测概率有所增加，从1.2%（出生于1948年至1952年）增至2.0%（出生于1963年至1967年）；而在50岁时，1938年至1942年出生者的住院概率为2.9%，相比之下，1953年至1957年出生的参与者为4.6%。在考虑年龄、出生年份和性别因素后，社会经济地位中等和较低者在观察期内住院的几率分别高出13.0%和20.0%。我们发现，在减少1915年至1972年出生队列间住院的社会经济不平等方面没有取得进展。因此，需要更有效的政策和干预措施来减轻总体发病负担，特别是在最脆弱人群中。
