Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, China.
Front Public Health. 2021 Nov 5;9:749640. doi: 10.3389/fpubh.2021.749640. eCollection 2021.
Adverse childhood experiences (ACEs) refer to traumatic events experienced by children in early life, including abuse, neglect, and family dysfunction, which are common worldwide. ACEs are harmful to mental health, and psychological problems can influence personal economic poverty in adulthood. We focused on family dysfunction and discussed the effect of different types of ACEs on poverty and the corresponding mediating effect of depression. A total of 9,910 individuals who were 60 years or older from the China Health and Retirement Longitudinal Study in 2014 and 2015 were analysed. The chi-square test was used to compare poverty incidence among subgroups of independent or control variables. Binary logistic regression analysis was used to test the effect of different types of ACEs on depression, and four logistic regression models were established to observe the association between ACEs on older adult poverty and the mediating effect of depression. The path diagram of the direct effect and indirect effect was drawn to test the mediating effect of depression. Early death of father, the male guardian getting upset and witnessing violence of father to mother are the risk factors for older adult poverty, whereas female guardian getting upset, relationship with female guardians and parental quarrel are protective factors for older adult poverty. Furthermore, depression has a partial mediating effect on some factors including early death of father, male guardian getting upset, relationship with female guardian, parental quarrel, and witnessing violence of father to mother. Paternal ACE factors can directly make children more likely to fall into poverty as older adults and can indirectly influence older adult poverty through the partial mediating effect of depression. Assisting poor families, providing psychological counselling, formulating family visit plans, nurturing orphan children under state supervision, and other policies that focus on groups that have experienced paternal ACE events are essential to eliminating the risk factors that influence older adult poverty.
不良童年经历（ACEs）是指儿童在早期生活中经历的创伤事件，包括虐待、忽视和家庭功能障碍，这些问题在全球范围内都很普遍。ACEs 对心理健康有害，心理问题会影响个人成年后的经济贫困。我们专注于家庭功能障碍，并讨论了不同类型的 ACEs 对贫困的影响，以及抑郁的中介作用。 我们分析了 2014 年和 2015 年来自中国健康与退休纵向研究的 9910 名 60 岁或以上的个体。使用卡方检验比较独立或控制变量亚组的贫困发生率。使用二元逻辑回归分析检验不同类型 ACEs 对抑郁的影响，并建立四个逻辑回归模型观察 ACEs 与老年贫困的关系以及抑郁的中介作用。绘制直接效应和间接效应的路径图来检验抑郁的中介效应。 父亲早逝、男性监护人情绪激动、目睹父亲对母亲的暴力行为是老年贫困的危险因素，而女性监护人情绪激动、与女性监护人的关系和父母争吵则是老年贫困的保护因素。此外，抑郁对包括父亲早逝、男性监护人情绪激动、与女性监护人的关系、父母争吵和目睹父亲对母亲的暴力行为在内的一些因素具有部分中介效应。 父亲 ACE 因素可以直接使孩子更有可能在成年后陷入贫困，也可以通过抑郁的部分中介效应间接影响老年贫困。援助贫困家庭、提供心理咨询、制定家庭探访计划、养育国家监护的孤儿等政策，关注经历过父亲 ACE 事件的群体，对于消除影响老年贫困的风险因素至关重要。
