中国农村地区生殖史与老年人多维健康的关系及其性别差异：来自中国长寿纵向研究的证据。
The association between reproductive history and the multidimensional health of older adults in rural China and its gender differences: Evidence from the Chinese longitudinal healthy longevity survey.
机构信息
School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China.
Policy Research Center, Ministry of Civil Affairs of China, Beijing, China.
出版信息
Front Public Health. 2022 Jul 27;10:952671. doi: 10.3389/fpubh.2022.952671. eCollection 2022.
BACKGROUND
Few studies have examined the association between reproductive history and the multidimensional health of older adults with more diverse reproductive histories and poorer health status in rural China. The purpose of this study is to explore the effect of parity, sex ratio of children and late childbearing on multidimensional health and its gender differences.
METHODS
The analytical sample consisted of 3,377 older adults in rural China who participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018. Linear regression models were applied to estimate the relationship between reproductive history and multidimensional health, with separate models for each indicator of health outcomes.
RESULTS
Older adults in rural areas with greater parity were more likely to have better cognitive function (β = 0.409, 95% CI: 0.255-0.563), fewer Activities of Daily Living (ADL) limitations (β = -0.085, 95% CI: -0.137 to -0.034) and symptoms of depression (β = -0.396, 95% CI: -0.577 to -0.216). The social mechanism of intergenerational support from children later in life partly explained the positive effect of parity. Late childbearing had negative effects on cognitive function (β = -1.220, 95% CI: -1.895 to -0.545), ADL (β = 0.253, 95% CI: 0.028-0.478) and symptoms of depression (β = 1.025, 95% CI: 0.237-1.812). Women were more likely to be influenced by the positive effect of parity; the association between late childbearing and health was only significant in the male group.
CONCLUSIONS
Parity and late childbearing are associated with cognitive function, activities of daily living, and symptoms of depression in the older adults in rural China. Older adults with more children might be in better health, and this finding is especially significant in women. However, late childbearing had a negative effect on multidimensional health, especially for men. The social mechanism and gender differences between reproductive history and health need to be further explored.
背景
在中国农村，很少有研究关注生育史与老年人多维健康之间的关系，而这些老年人具有更多样化的生育史和较差的健康状况。本研究旨在探讨生育胎次、子女性别比和晚育对多维健康的影响及其性别差异。
方法
本分析样本包括 2018 年参加中国长寿纵向研究（CLHLS）的 3377 名农村老年人。采用线性回归模型来估计生育史与多维健康之间的关系，每个健康结果指标都有单独的模型。
结果
农村地区生育胎次较多的老年人认知功能更好（β=0.409，95%CI：0.255-0.563），日常生活活动（ADL）受限更少（β=-0.085，95%CI：-0.137 至-0.034），抑郁症状更少（β=-0.396，95%CI：-0.577 至-0.216）。来自子女的代际支持的社会机制部分解释了生育胎次的积极影响。晚育对认知功能（β=-1.220，95%CI：-1.895 至-0.545）、ADL（β=0.253，95%CI：0.028-0.478）和抑郁症状（β=1.025，95%CI：0.237-1.812）有负面影响。女性更容易受到生育胎次的积极影响；晚育与健康的关联仅在男性组中具有统计学意义。
结论
在中国农村，生育胎次和晚育与老年人的认知功能、日常生活活动和抑郁症状有关。生育子女较多的老年人可能健康状况更好，这一发现对女性尤为显著。然而，晚育对多维健康有负面影响，尤其是对男性。需要进一步探讨生育史与健康之间的社会机制和性别差异。
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