Peck M N
Swedish Institute for Social Research, Stockholm University.
Soc Sci Med. 1994 Aug;39(4):553-62. doi: 10.1016/0277-9536(94)90098-1.
Socio-economic conditions in childhood and their effect on morbidity and mortality in adult life have been discussed frequently during the last 10 years or so. At least two hypotheses have been discussed. The hypothesis that perinatal and childhood conditions are directly and causally related to morbidity and mortality has been met by a critique, the essence of which is that the relationship could be an indirect one. Those experiencing poor conditions early in life are more likely to experience poor conditions later in life and the association between perinatal and childhood factors and adult health is mediated by adult social factors. Here, this alternative hypothesis is tested on a sample drawn from the Swedish population. The sample was interviewed in 1980-81 and the register of those who consented to the interview included 6298 men and 6397 women aged 16-74 years. This register was linked to the Cause of Death Register for the period 1980-88. 461 men and 289 women died during the follow up. Firstly it is concluded that childhood socio-economic group is significantly linked to male mortality, when age is taken into account. This could not be demonstrated for women. The variation in general health between childhood socio-economic groups, on the other hand, is significant for women but not for men. When a number of mediating variables are added, the effect of childhood socio-economic group remains significant for men. It is thus not possible to exclude the possibility that childhood socio-economic conditions have a direct effect on adult health. At the same time, it is suggested here that at least a part of that effect is mediated by social factors in adulthood. That childhood socio-economic conditions may be independently related to adult health does not support the hypothesis of 'biological programming'.
在过去十年左右的时间里，人们经常讨论童年时期的社会经济状况及其对成年后发病率和死亡率的影响。至少讨论了两种假设。围产期和童年时期的状况与发病率和死亡率直接且存在因果关系这一假设受到了批评，其核心观点是这种关系可能是间接的。早年经历不佳状况的人在晚年更有可能经历不佳状况，围产期和童年时期因素与成年健康之间的关联是由成年后的社会因素介导的。在此，针对从瑞典人口中抽取的样本对这一替代假设进行了检验。该样本于1980 - 1981年接受了访谈，同意接受访谈者的登记册中有6298名年龄在16 - 74岁之间的男性和6397名女性。这个登记册与1980 - 1988年期间的死亡原因登记册相关联。在随访期间，有461名男性和289名女性死亡。首先得出的结论是，考虑到年龄因素，童年时期的社会经济群体与男性死亡率显著相关。而对于女性则无法证明这一点。另一方面，童年社会经济群体之间总体健康状况的差异对女性来说是显著的，对男性则不然。当加入一些中介变量后，童年社会经济群体对男性的影响仍然显著。因此，不可能排除童年社会经济状况对成年健康有直接影响的可能性。同时，这里表明这种影响至少有一部分是由成年后的社会因素介导的。童年社会经济状况可能与成年健康独立相关这一点并不支持“生物编程”假说。
