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国家能否塑造累积逆境与老年健康之间的关联?

Can countries shape the association between cumulative adversity and old-age health?

机构信息

The Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel.

出版信息

Front Public Health. 2024 May 15;12:1364868. doi: 10.3389/fpubh.2024.1364868. eCollection 2024.

Abstract

INTRODUCTION

The present study examined the relationships of Lifetime Cumulative Adversity (LCA) and country inequalities, as well as the interactions between them, with the self-rated health (SRH) in old age.

METHODS

Using data from the Survey of Health, Aging and Retirement in Europe (SHARE), the study regressed self-rated health on Lifetime Cumulative Adversity and country-level inequality indices across European countries in two points in time. The analysis also considered adversity-inequality interactions, controlling for confounders. The sample was comprised of 28,789 adults, aged 50 to 80, from 25 European countries and Israel.

RESULTS

The findings pointed out that LCA is negatively associated with SRH, but democracy and welfare regimes modify the ill effects of LCA on health. These effects are reduced as the LCA level increases. The effects remained significant over two measurement time-points over three years, showing that life-course trajectories may be shaped by individual accumulated risk exposure to stress, along with inequalities at the society level.

DISCUSSION

The study provides constructive and important guidance for decreasing the harmful effect of lifetime adversity in old age, by the modification of the country's welfare policies.

摘要

简介

本研究考察了一生中累积逆境(LCA)与国家不平等之间的关系,以及它们之间的相互作用,与老年人的自我报告健康(SRH)的关系。

方法

利用来自欧洲健康、老龄化和退休调查(SHARE)的数据,本研究在两个时间点上,根据欧洲各国的一生中累积逆境和国家不平等指数,对自我报告的健康状况进行回归分析。分析还考虑了逆境-不平等的相互作用,同时控制了混杂因素。样本包括来自 25 个欧洲国家和以色列的 28789 名 50 至 80 岁的成年人。

结果

研究结果表明,LCA 与 SRH 呈负相关,但民主和福利制度改变了 LCA 对健康的不良影响。随着 LCA 水平的升高,这些影响会降低。这些影响在三年内的两个测量时间点上仍然显著,表明个体一生中累积的压力风险暴露以及社会层面的不平等可能会影响到生命轨迹。

讨论

该研究为通过修改国家福利政策来降低老年人一生中逆境的有害影响提供了有益的重要指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a80/11133626/c77079db9eda/fpubh-12-1364868-g001.jpg

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