School of Pharmacy and Health Sciences, Fairleigh Dickinson University, Florham Park, NJ, USA.
George Warren Brown School, Washington University in St. Louis, Saint Louis, MO, USA.
Aging Ment Health. 2022 Nov;26(11):2136-2148. doi: 10.1080/13607863.2021.1951659. Epub 2021 Jul 21.
A growing number of life course studies are examining the influence of earlier life experiences on morbidity, disability, and mortality in mid-old age. Drawing from the social pathway model, this study expands the life course literature by utilizing data collected over 35 years from the National Longitudinal Survey of Youth, 1979 Cohort, spanning four life course phases (childhood, young adulthood, middle adulthood, and late-middle adulthood). Through structural equation analyses with a phantom model, we estimated depressive symptoms in late middle age as a result of pathway effects starting with childhood socio-economic status (SES) which effect young adulthood and middle adulthood. The multi-pathway life course model includes three potential mediators of middle adulthood: health risk behaviors, social activity, and negative life events. We found limited support for a direct effect of childhood SES disadvantage on depressive symptoms in middle age. Instead, much of the effects of childhood SES on later-year depressive symptoms appear to be mediated by SES in young adulthood. Further, the long-term pathway is mediated through the influence of health risk behaviors and negative life events in middle adulthood. Our findings do not propose this chain is permanent and irreversible; rather, this study highlights the possibility that interventions focused on promoting health behaviors and improving living conditions for people from socioeconomically disadvantaged backgrounds could help reduce the instance of depression in middle age and health outcomes along the life course could be improved.
越来越多的人生历程研究正在探讨早期生活经历对中年时期发病率、残疾和死亡率的影响。本研究借鉴社会途径模型,通过利用来自青年纵向研究 1979 年队列的数据,扩展了人生历程文献,该研究跨越了四个人生历程阶段(儿童期、青年期、中年期和中老年期),历时 35 年。通过对具有虚拟模型的结构方程进行分析,我们估计了中年后期的抑郁症状,这是由儿童时期社会经济地位(SES)开始的途径效应造成的,该效应影响了青年期和中年期。多途径人生历程模型包括中年期的三个潜在中介因素:健康风险行为、社会活动和负面生活事件。我们发现,儿童时期 SES 劣势对中年抑郁症状的直接影响有限。相反,儿童时期 SES 对以后年份抑郁症状的影响,在很大程度上是通过青年时期 SES 来中介的。此外,长期途径是通过中年期健康风险行为和负面生活事件的影响来介导的。我们的研究结果并不是说这个链条是永久性和不可逆转的;相反,本研究强调了这样一种可能性,即针对促进健康行为和改善社会经济背景较差人群生活条件的干预措施,可能有助于减少中年抑郁的发生,并改善人生历程中的健康结果。