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美国健康机会格局的变化:20 世纪 90 年代至 21 世纪 10 年代,儿童时期社会经济劣势与成年健康之间关联强度的增强。

A Changing Landscape of Health Opportunity in the United States: Increases in the Strength of Association Between Childhood Socioeconomic Disadvantage and Adult Health Between the 1990s and the 2010s.

出版信息

Am J Epidemiol. 2021 Nov 2;190(11):2284-2293. doi: 10.1093/aje/kwab060.

Abstract

Understanding the changing health consequences of childhood socioeconomic disadvantage (SED) is highly relevant to policy debates on inequality and national and state goals to improve population health. However, changes in the strength of association between childhood SED and adult health over historic time are largely unexamined in the United States. The present study begins to address this knowledge gap. Data were from 2 national samples of adults collected in 1995 (n = 7,108) and 2012 (n = 3,577) as part of the Midlife in the United States study. Three measures of childhood SED (parents' occupational prestige, childhood poverty exposure, and parents' education) were combined into an aggregate index and examined separately. The association between childhood SED (aggregate index) and 5 health outcomes (body mass index, waist circumference, chronic conditions, functional limitations, and self-rated health) was stronger in the 2012 sample than the 1995 sample, with the magnitude of associations being approximately twice as large in the more recent sample. Results persisted after adjusting for age, sex, race, marital status, and number of children, and were similar across all 3 measures of childhood SED. The findings suggest that the socioeconomic circumstances of childhood might have become a stronger predictor of adult health in recent decades.

摘要

了解儿童社会经济地位(SED)变化对健康的影响,与不平等政策辩论以及改善人口健康的国家和州目标高度相关。然而,在美国,历史上儿童 SED 与成人健康之间关联强度的变化在很大程度上尚未得到检验。本研究开始填补这一知识空白。数据来自作为美国中年研究一部分的 1995 年(n=7108)和 2012 年(n=3577)两次全国性成年人样本。将父母职业声望、童年贫困经历和父母教育程度这三个儿童 SED 指标合并为一个综合指数,并分别进行研究。儿童 SED(综合指数)与 5 项健康结果(体重指数、腰围、慢性疾病、功能障碍和自我评估健康)之间的关联在 2012 年样本中比 1995 年样本更强,最近样本中的关联幅度大约是前者的两倍。调整年龄、性别、种族、婚姻状况和子女数量后,结果仍然存在,并且在所有三个儿童 SED 指标中都相似。研究结果表明,近几十年来,儿童的社会经济环境可能已成为成人健康的更强预测因素。

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