Rähse Tobias, Richter Matthias, Knöchelmann Anja
Institute of Medical Sociology, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Saxony-Anhalt, Germany.
Department Health and Sport Sciences, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
BMC Public Health. 2025 Feb 4;25(1):446. doi: 10.1186/s12889-024-21135-y.
Life course epidemiology explores health disparities over time. The accumulation thesis thereby suggests an add-up of disadvantages, while the adaptation model assumes an adjustment to disadvantageous conditions. Examining the relevance of these accumulation and adaptation processes, the present study analyses continuing exposure to various material and perceived economic factors on self-rated health (SRH) across different life stages.
All analyses are based on longitudinal data from the German Socio-Economic Panel (SOEP) from 1994 to 2017. Exposure variables, including loan burdens, housing status and quality (material factors) as well as financial and occupational worries, housing and income satisfaction (perceived economic factors), were analyzed dichotomously. Exposure duration was calculated as observed years in exposure for each of the factors, taking only continuous exposure years into account. The analyses were carried out separately for sex and life stages (emerging, early middle & later middle, late adulthood) using fixed effects models to adjust for time-varying covariates.
The analyses showed accumulation processes associated with housing status, financial worries and income satisfaction impacting SRH across most life stages. The effects of continuing exposure to occupational worries, housing satisfaction, housing quality, and loan burdens were more variable, indicating accumulation processes in certain life stages and sex-specific variations.
While predominantly accumulation effects were found for certain factors, others showed more varied patterns. Future research should explore the mechanisms underlying these effects to develop well-timed measures that mitigate the negative health implications of continuing exposures to disadvantageous factors, emphasizing the importance of multiple exposures and later life health effects that may impede healthy ageing.
生命历程流行病学研究随时间变化的健康差异。累积理论认为劣势会不断累加,而适应模型则假定个体能适应不利状况。本研究通过考察这些累积和适应过程的相关性,分析了在不同生命阶段持续暴露于各种物质和感知到的经济因素对自评健康(SRH)的影响。
所有分析均基于1994年至2017年德国社会经济面板(SOEP)的纵向数据。对包括贷款负担、住房状况和质量(物质因素)以及财务和职业担忧、住房和收入满意度(感知到的经济因素)等暴露变量进行二分法分析。暴露持续时间按每个因素的观察暴露年数计算,仅考虑连续暴露年数。使用固定效应模型对性别和生命阶段(青年、中青年和中老年、老年)分别进行分析,以调整随时间变化的协变量。
分析表明,在大多数生命阶段,住房状况、财务担忧和收入满意度等累积过程会影响自评健康。持续暴露于职业担忧、住房满意度、住房质量和贷款负担的影响则更具变化性,表明在某些生命阶段存在累积过程以及性别差异。
虽然某些因素主要呈现累积效应,但其他因素则表现出更多样化的模式。未来的研究应探索这些效应背后的机制,以制定适时的措施,减轻持续暴露于不利因素对健康的负面影响,强调多重暴露以及可能阻碍健康老龄化的晚年健康影响的重要性。