Yu Zexuan, Qin Wen, Li Jiajia
Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Biostatistics, Brown University School of Public Health, Providence, RI, United States.
Front Med (Lausanne). 2023 Jan 9;9:842817. doi: 10.3389/fmed.2022.842817. eCollection 2022.
BACKGROUND: Risky health behaviors in childhood, including smoking, alcohol consumption, and having a poor diet, are the major sources of non-communicable diseases in adulthood. This study aimed to examine how parents affect children's risky health behaviors and whether intergenerational transmission differs based on socioeconomic status (SES). METHODS: Data were extracted from the 1991-2015 China Health and Nutrition Survey (CHNS). Smoking ( = 5,946), alcohol consumption ( = 7,821), and sugar-sweetened beverages (SSBs) consumption ( = 3,537) were used as proxies for risky health behaviors in children. A binary choice model for panel data with a random-effect specification was employed to examine whether risky health behaviors can be transmitted from parents to their children. Subsequently, we conducted a seemingly unrelated estimation test (SUEST) to explore the differences in parental transmission between the different SES groups. RESULTS: We found strong intergenerational persistence of smoking, alcohol drinking, and SSBs drinking behaviors, except for the mothers' smoking behavior. Mothers had a greater influence on children's alcohol drinking and SSBs drinking behaviors than fathers both in urban and rural areas and in different SES groups. The intergenerational transmission of SSBs drinking behavior exhibited a decreasing trend with increasing SES for both urban and rural families. In urban areas, mothers' alcohol drinking behavior has a decreasing trend with increasing education level, occupation, and income; however, in rural areas, the influence of mothers' alcohol drinking behavior occurred in the same direction with increasing education level and occupation type. In rural areas, the influence of fathers' drinking and smoking behaviors on children appears to mostly increase with increasing SES. Meanwhile, the influence of such behaviors among urban fathers would decrease with increasing SES. CONCLUSION: Parents' behaviors and SES can influence the initiation of risky health behaviors in their offspring. Thus, to promote healthy behaviors, policymakers can introduce health education programs for parents, particularly for those living in rural areas and with a low SES.
背景:儿童时期的危险健康行为,包括吸烟、饮酒和饮食不良,是成年后非传染性疾病的主要来源。本研究旨在探讨父母如何影响孩子的危险健康行为,以及代际传播是否因社会经济地位(SES)而异。 方法:数据取自1991 - 2015年中国健康与营养调查(CHNS)。吸烟(n = 5946)、饮酒(n = 7821)和含糖饮料(SSB)消费(n = 3537)被用作儿童危险健康行为的指标。采用具有随机效应设定的面板数据二元选择模型,以检验危险健康行为是否能从父母传给子女。随后,我们进行了看似不相关的估计检验(SUEST),以探索不同SES组之间父母传播的差异。 结果:我们发现吸烟、饮酒和饮用SSB行为存在很强的代际持续性,但母亲的吸烟行为除外。在城市和农村地区以及不同SES组中,母亲对孩子饮酒和饮用SSB行为的影响均大于父亲。城乡家庭饮用SSB行为的代际传播均呈现出随SES升高而下降的趋势。在城市地区,母亲的饮酒行为随教育水平、职业和收入的提高呈下降趋势;然而,在农村地区,母亲饮酒行为的影响随教育水平和职业类型的提高呈相同方向变化。在农村地区,父亲的饮酒和吸烟行为对孩子的影响似乎大多随SES升高而增加。与此同时,城市父亲的此类行为影响会随SES升高而降低。 结论:父母的行为和SES会影响其后代危险健康行为的产生。因此,为促进健康行为,政策制定者可以为父母,特别是那些生活在农村地区且SES较低的父母,推出健康教育项目。
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