School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.
State Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China.
Front Public Health. 2021 Feb 3;9:642520. doi: 10.3389/fpubh.2021.642520. eCollection 2021.
This study examined the relationship between childhood circumstances and health in middle and later life. We quantified how childhood circumstances contribute to health in later life, both directly and indirectly, through their effects on potential mediators. This study used three waves of data from the national longitudinal survey of the China Health and Retirement Longitudinal Study (CHARLS). The final model in this study included 7,476 eligible respondents aged 45 years and above. We constructed a simple health status measure based on the first principal component of CHARLS survey responses with 25 health-related information. It is a multi-dimensional measurement that comprehensively reflects the individual's healthy aging. We formulated childhood circumstances factors into five domains: childhood health and nutrition, childhood socioeconomic status, access to health care, parental genetics, and adverse childhood experiences. Ordered logit regression was conducted to analyze the relationship between health in middle and later life and childhood circumstances, with other explanatory variables controlled. Controlling for educational attainment, personal income, and health status in the last wave, adults who experience good childhood health (poor as the base, coefficient 0.448, < 0.01), and better family financial status (worse as the base, coefficient 0.173, < 0.01) have significantly better health during their middle and later life, in comparison, being inconvenient to visit a doctor (coefficient -0.178, < 0.01), and having two or three adverse childhood experiences (0 as the base, coefficient -0.148, < 0.01) are significantly associated with poorer health. Childhood circumstances appear to act both through a lasting effect of initial health and financial status in childhood and through their impact on achievements in adulthood. Our findings suggest that investments in health during childhood not only contribute to health in later life but also dynamically improve an individual's educational attainment and personal income, as well as other life prospects. All these returns may extend far beyond childhood and continue throughout the lifespan.
本研究考察了童年环境与中老年健康之间的关系。我们量化了童年环境通过对潜在中介因素的影响，对中老年健康的直接和间接贡献。本研究使用了中国健康与养老追踪调查（CHARLS）的三波数据。最终模型包括 7476 名年龄在 45 岁及以上的合格受访者。我们根据 CHARLS 调查响应中的第一个主成分构建了一个简单的健康状况衡量标准，该标准包含 25 个与健康相关的信息。这是一个多维的衡量标准，全面反映了个体的健康老龄化。我们将童年环境因素分为五个领域：儿童健康和营养、儿童社会经济地位、获得医疗保健、父母遗传和不良童年经历。我们对中年和晚年健康与童年环境之间的关系进行了有序逻辑回归分析，并控制了其他解释变量。在控制了教育程度、个人收入和最后一波的健康状况后，与童年健康状况较差的成年人相比（较差作为基础，系数 0.448， < 0.01），童年健康状况较好的成年人在中年和晚年的健康状况明显更好，而家庭经济状况较好的成年人（较差作为基础，系数 0.173， < 0.01）也具有更好的健康状况。相比之下，就医不便（系数-0.178， < 0.01）和经历过两种或三种不良童年经历（0 作为基础，系数-0.148， < 0.01）的成年人与较差的健康状况显著相关。童年环境似乎通过童年时期初始健康和财务状况的持久影响以及对成年期成就的影响来发挥作用。我们的研究结果表明，对儿童健康的投资不仅有助于晚年健康，还能动态提高个人的教育程度和个人收入以及其他生活前景。所有这些回报可能远远超出童年时期，并持续一生。
