Wang Qing, Kang Wenwen
School of Public health, Shandong University, Jinan, 250012, China; School of Business, Dalian University of Technology, Panjin, 124221, Liaoning, China.
School of Business, Dalian University of Technology, Panjin, 124221, Liaoning, China.
Adv Life Course Res. 2019 Dec;42:100289. doi: 10.1016/j.alcr.2019.100289. Epub 2019 May 4.
It is well known that in western countries, people with disadvantaged socioeconomic circumstances during childhood are at a significantly higher risk of ill health in older age. This study further questions whether in China, individuals' different childhood socioeconomic circumstances and social status continue to affect their life-long health. Furthermore, do later-life socioeconomic circumstances affect health so that childhood conditions no longer play a significant role? The influence of social mobility and accumulation was also tested. The analysis was based on the China Health and Retirement Longitudinal Study (CHARLS) 2013 and CHARLS life history survey. Health outcomes were measured based on self-reported health, disability for activities of daily life, depression symptoms, and cognitive impairment. In addition to measurements of childhood, the analysis included current socioeconomic circumstances, current health behaviors, and demographic characteristics. Using ordered logit or logit and Ordinary Least Square (OLS) regression models, the study shows the existence of the association between childhood conditions and later health in China. After adjusting for current socioeconomic circumstances, social status was no longer related to later health. However, childhood socioeconomic circumstances still significantly influenced health at a later age. Advantaged socioeconomic circumstances in the life course (high stability) provided the best protection for later health. However, moving downward-that is, experiencing childhood socioeconomic advantage but later-life socioeconomic disadvantage-was the most detrimental to later health. Overall, this study provides new evidence from China to support the notion that health in older age is related to dynamic processes structured by the social stratification system. Thus, this study emphasizes an integrated health policy based on the premise of maximizing health over the entire life course.
众所周知，在西方国家，童年时期社会经济状况处于劣势的人在老年时健康状况不佳的风险要高得多。本研究进一步探讨在中国，个人童年时期不同的社会经济状况和社会地位是否会持续影响他们一生的健康。此外，晚年的社会经济状况是否会影响健康，以至于童年时期的状况不再起重要作用？社会流动和积累的影响也进行了测试。分析基于2013年中国健康与养老追踪调查（CHARLS）以及CHARLS生活史调查。健康结果基于自我报告的健康状况、日常生活活动能力残疾、抑郁症状和认知障碍来衡量。除了对童年时期的测量外，分析还包括当前的社会经济状况、当前的健康行为和人口统计学特征。使用有序逻辑回归或逻辑回归以及普通最小二乘法（OLS）回归模型，该研究表明在中国童年状况与晚年健康之间存在关联。在调整了当前的社会经济状况后，社会地位与晚年健康不再相关。然而，童年时期的社会经济状况仍然对晚年健康有显著影响。生命历程中优越的社会经济状况（高稳定性）为晚年健康提供了最佳保护。然而，向下流动——即童年时期具有社会经济优势但晚年处于社会经济劣势——对晚年健康最为不利。总体而言，本研究提供了来自中国的新证据，支持老年健康与社会分层系统构建的动态过程相关这一观点。因此，本研究强调基于在整个生命历程中最大化健康这一前提的综合健康政策。
