儿童期家庭冲突和经济压力对成年后身心健康受损的累积风险：基于对 19 个欧洲国家具有代表性的调查数据的回顾性分析。
Cumulative risk of compromised physical, mental and social health in adulthood due to family conflict and financial strain during childhood: a retrospective analysis based on survey data representative of 19 European countries.
机构信息
The Danish National Institute of Public Health, Syddansk Universitet, Copenhagen, Denmark.
Reserca, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Catalunya, Spain.
出版信息
BMJ Glob Health. 2021 Mar;6(3). doi: 10.1136/bmjgh-2020-004144.
BACKGROUND
Childhood adversity (CA) has previously been linked to various health problems in adulthood. Investigations into the differential impact of distinct types of CA on a wide range of outcomes are scarce. This study aimed to assess the impact of self-reported childhood family conflict and/or financial strain on health and social functioning in adulthood among Europeans, while taking into account the mediating role of adulthood socioeconomic disadvantage (SED) in these associations.
METHODS
Using the European Social Survey (ESS) collected in 2014, nationally representative cross-sectional data from 35 475 participants aged 15 years and older in 19 European countries were analysed. Logistic regressions were conducted to assess associations of retrospectively reported family conflict and/or financial strain in childhood with physical and mental health as well as health behaviours and social functioning in adulthood.
RESULTS
A quarter of the European population reported having experienced family conflict, financial strain or both in childhood. Financial strain was reported more among older age groups and conflict more among younger age groups. A dose-response pattern with increased risk was demonstrated for almost all physical, behavioral, mental and social outcomes for these aspects of CA compared with no CA, with the highest risk observed in those who experienced both financial strain and family conflict. Adulthood SED mediated a significant proportion of the associations with financial strain (ranging from 5.4% to 72.4%), but did not mediate the associations with conflict.
CONCLUSION
Individuals reporting family conflict or financial strain during childhood are at increased risk of developing a wide range of health and social problems. Those who report financial strain in childhood are more likely to experience SED in adulthood, which in turn increases their risk of experiencing health and social problems. Reported family conflict during childhood conferred increased risk of health and social problems, but adulthood SED did not appear to operate as an indirect pathway.
背景
童年逆境（CA）先前与成年后的各种健康问题有关。对于不同类型的 CA 对广泛的结果的差异影响的研究很少。本研究旨在评估在考虑到这些关联中成年社会经济劣势（SED）的中介作用的情况下，自我报告的童年家庭冲突和/或经济压力对欧洲成年人健康和社会功能的影响。
方法
使用 2014 年收集的欧洲社会调查（ESS），对来自 19 个欧洲国家的 35475 名年龄在 15 岁及以上的参与者的全国代表性横断面数据进行了分析。进行逻辑回归以评估儿童时期回忆的家庭冲突和/或经济压力与成年期身心健康以及健康行为和社会功能的关联。
结果
四分之一的欧洲人口报告在童年时期经历过家庭冲突、经济压力或两者兼有。经济压力在年龄较大的人群中报告较多，而冲突在年龄较小的人群中报告较多。与没有 CA 的人群相比，几乎所有与 CA 相关的身体、行为、心理和社会结果都表现出剂量反应模式，风险增加，而经历过经济压力和家庭冲突的人群的风险最高。在与经济压力相关的关联中，成年 SED 介导了很大一部分（范围从 5.4%到 72.4%），但与冲突无关。
结论
报告在童年时期经历家庭冲突或经济压力的个体发生一系列健康和社会问题的风险增加。那些在童年时期报告经济压力的人更有可能在成年后经历 SED，这反过来又增加了他们经历健康和社会问题的风险。报告的童年家庭冲突增加了健康和社会问题的风险，但成年 SED 似乎不是间接途径。
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