儿童期社会经济地位与中老年健康的关系研究

doi:10.12114/j.issn.1007-9572.2019.00.012

摘要/Abstract

摘要： 儿童期社会经济地位是指儿童期的社会阶层和父母教育程度的认知，近年来研究表明其与中老年健康相关，不良的儿童期社会经济地位可能导致中老年出现严重的健康问题，其是从整个生命周期的角度探讨中老年健康的影响因素。生命历程健康发展理论、路径模型及变动模型将儿童期社会经济地位与中老年健康进行关联。儿童期社会经济地位影响中老年健康的发生机制包括环境因素和医疗卫生服务的可及性等。本文应用生命历程健康发展理论、路径模型及变动模型阐述儿童期社会经济地位与中老年健康的关系及其发生机制。

关键词: 儿童, 社会经济地位, 中老年, 健康状况, 机制

Abstract: Childhood socioeconomic status（SES） refers to the parental social class and parental education in childhood.Recent research has proved that SES influences the health in middle-old age.In particular，studies of the influencing factors for health in middle-old age from the perspective of life cycle show that low SES may lead to serious health conditions in middle-old age.Life course health development （LCHD），the pathway model and the social mobility model explain the association of childhood SES with health in middle-old age.The mechanism of childhood SES influences the health in middle-old age involves environmental factors，and the accessibility of health services.This paper introduces LCHD，the pathway model and the social mobility model，to explain the mechanism of the association of childhood SES with the health in middle-old age.

Key words: Child, Socioeconomic status, Middle-old age, Health status, Mechanism

张小宁,陈爽,孟坤,等. 儿童期社会经济地位与中老年健康的关系研究[J]. 中国全科医学, 2019, 22(7): 849-854. DOI: 10.12114/j.issn.1007-9572.2019.00.012.
ZHANG Xiaoning,CHEN Shuang,MENG Kun, et al. Association of Childhood Socioeconomic Status with Health in Middle-old Age　[J]. Chinese General Practice, 2019, 22(7): 849-854. DOI: 10.12114/j.issn.1007-9572.2019.00.012.

参考文献

［1］GOSSMAN M.On the concept of health capital and the demand for health［J］．Eur J Polit Econ，1972，2：223-255.DOI：10.1086/259880.
［2］薛新东，葛凯啸.社会经济地位对我国老年人健康状况的影响：基于中国老年健康影响因素调查的实证分析［J］．人口与发展，2017，23（2）：61-69.DOI：10.3969/j.issn.1674-1668.2017.02.007.
XUE X D，GE K X.The effect of socioeconomic status on the health of the elderly in China：evidence from the Chinese longitudinal healthy longevity survey［J］．Population and Development，2017，23（2）：61-69.DOI：10.3969/j.issn.1674-1668.2017.02.007.
［3］GOUGH H G.The relationship of socioeconomic status to personality inventory and achievement test scores［J］．J Educ Psychol，1946，37（9）：527-540.DOI：10.1037/h0055013.
［4］CHAPIN F S.A quantitative scale for rating the home and social environment of middle class families in an urban community［J］．Educ Psychol，1928，19：99-111.DOI：10.1037/h0074500.
［5］SHAW M.Health inequality：an introduction to theories，concepts and methods［J］．Int J Epidemiol，2005，34（2）：500-502.
［6］MUELLER C W，PARCEL T L.Measures of socioeconomic status：alternatives and recommendations［J］．Child Dev Res，1981，52（1）：13-30.
［7］张卫，李董平，谢志杰.低社会经济地位与儿童发展［J］．华南师范大学学报（社会科学版），2007，52（6）：104-112.DOI：10.3969/j.issn.1000-5455.2007.06.018.
ZHANG W，LI D P，XIE Z J.Low socioeconomic status and child development［J］．Journal of South China Normal University（Social Science Edition），2007，52（6）：104-112.DOI：10.3969/j.issn.1000-5455.2007.06.018.
［8］MITCHELL A M，KOWALSKY J M，EPEL E S，et al．Childhood adversity，social support，and telomere length among perinatal women［J］．Psychoneuroendocrinology，2018，87：43-52.DOI：10.1016/j.psyneuen.2017.10.003.
［9］黄洁萍，尹秋菊.社会经济地位对人口健康的影响：以生活方式为中介机制［J］．人口与经济，2013，34（3）：26-34.DOI：10.3969/j.issn.1000-4149.2013.03.004.
HUANG J P，YIN Q J.The effects of socioeconomic status on health：based on lifestyle mediator［J］．Population & Economics，2013，34（3）：26-34.DOI：10.3969/j.issn.1000-4149.2013.03.004.
［10］MURAYAMA H，FUJIWARA T，TANI Y，et al．Long-term impact of childhood disadvantage on late-life functional decline among older Japanese：results from the JAGES prospective cohort study［J］．J Gerontol A Biol Sci Med Sci，2018，73（7）：973-979.DOI：10.1093/gerona/glx171.
［11］SHEIKH M A.Childhood adversities and chronic conditions：examination of mediators，recall bias and age at diagnosis［J］．Int J Public Health，2018，63（2）：181-192.DOI：10.1007/s00038-017-1021-2.
［12］ZHONG Y，WANG J，NICHOLAS S.Gender，childhood and adult socioeconomic inequalities in functional disability among Chinese older adults［J］．Int J Equity Health，2017，16（1）：165.DOI：10.1186/s12939-017-0662-3.
［13］VABLE A M，GILSANZ P，NGUYEN T T，et al．Validation of a theoretically motivated approach to measuring childhood socioeconomic circumstances in the Health and Retirement Study［J］．PLoS One，2017，12（10）：e0185898.DOI：10.1371/journal.pone.0185898.
［14］PORTRAIT F，TEEUWISZEN E，DEEG D.Early life undernutrition and chronic diseases at older ages：the effects of the Dutch famine on cardiovascular diseases and diabetes［J］．Soc Sci Med，2011，73（5）：711-718.DOI：10.1016/j.socscimed.2011.04.005.
［15］HAAS S A.The long-term effects of poor childhood health：an assessment and application of retrospective reports［J］．Demography，2007，44（1）：113-135.
［16］PALLONI A，MCENIRY M，WONG R，et al．The tide to come：elderly health in Latin America and the Caribbean［J］．J Aging Health，2006，18（2）：180-206.
［17］LEE M，KHAN M M，WRIGHT B.Is childhood socioeconomic status related to coronary heart disease? Evidence from the Health and Retirement Study（1992—2012）［J］．Gerontol Geriatr Med，2017，3：1-9.DOI：10.1177/2333721417696673.
［18］PUOLAKKA E，PAHKALA K，LAITINEN T T，et al．Childhood socioeconomic status and arterial stiffness in adulthood：the cardiovascular risk in Young Finns Study［J］．Hypertension，2017，70（4）：729-735.DOI：10.1161/HYPERTENSIONAHA.117.09718.
［19］GLYMOUR M M，AVENDANO M，HAAS S，et al．Life course social conditions and racial disparities in incidence of first stroke［J］．Ann Epidemiol，2008，18（12）：904-912.DOI：10.1016/j.annepidem.2008.09.010.
［20］LIU L，XUE F，MA J，et al．Social position and chronic conditions across the life span and risk of stroke：a life course epidemiological analysis of 22 847 American adults in ages over 50［J］．Int J Stroke，2013，8（100）：50-55.DOI：10.1111/j.1747-4949.2012.00927.x.
［21］王思平，王娟.社会经济地位评价方法及与卒中关系的研究进展［J］．中国脑血管病杂志，2016，13（11）：610-613.DOI：10.3969/j.issn.1672-5921.2016.11.011.
WANG S P，WANG J.Research progress on the evaluation method of socioeconomic status and its relationship with stroke［J］．Chinese Journal of Cerebrovascular Diseases，2016，13（11）：610-613.DOI：10.3969/j.issn.1672-5921.2016.11.011.
［22］LISTL S，BROADBENT J M，THOMSON W M，et al．Childhood socioeconomic conditions and teeth in older adulthood：evidence from SHARE wave 5［J］．Br Dent J，2018，224（5）：357.DOI：10.1038/sj.bdj.2018.196.
［23］CRANDALL C J，MERKIN S S，SEEMAN T E，et al．Socioeconomic status over the life-course and adult bone mineral density：the midlife in the U.S. study［J］．Bone，2012，51（1）：107-113.DOI：10.1016/j.bone.2012.04.009.
［24］HARGROVE T W，BROWN T H.A life course approach to inequality：examining racial/ethnic differences in the relationship between early life socioeconomic conditions and adult health among men［J］．Ethnicity & Disease，2015，25（3）：313-320.DOI：10.18865/ed.25.3.313.
［25］GURALNIK J M，BUTTERWORTH S，WADSWORTH M E，
et al．Childhood socioeconomic status predicts physical functioning a half century later［J］．J Gerontol A Biol Sci Med Sci，2006，61（7）：694-701.
［26］BOWEN M E.Childhood socioeconomic status and racial differences in disability：evidence from the Health and Retirement Study （1998—2006）［J］．Soc Sci Med，2009，69（3）：433-441.DOI：10.1016/j.socscimed.2009.06.006.
［27］ZHANG Z，LIU J，LI L，et al．The long arm of childhood in China：early-life conditions and cognitive function among middle-aged and older adults［J］．J Aging Health，2018，30（8）：1319-1344.DOI：10.1177/0898264317715975.
［28］YI Z，GU D，LAND K C.The association of childhood socioeconomic conditions with healthy longevity at the oldest-old ages in China［J］．Demography，2007，44（3）：497-518.
［29］TAYLOR S E.Mechanisms linking early life stress to adult health outcomes［J］．Proc Natl Acad Sci U S A，2010，107（19）：8507-8512.DOI：10.1073/pnas.1003890107.
［30］SHEIKH M A，ABELSEN B，OLSEN J A.Clarifying associations between childhood adversity，social support，behavioral factors，and mental health，health，and well-being in adulthood：a population-based study［J］．Front Psychol，2016，7：727.DOI：10.3389/fpsyg.2016.00727.
［31］SCHAAN B.The interaction of family background and personal education on depressive symptoms in later life［J］．Soc Sci Med，2014，102：94-102.DOI：10.1016/j.socscimed.2013.11.049.
［32］SHEIKH M A，ABELSEN B，OLSEN J A.Role of respondents' education as a mediator and moderator in the association between childhood socio-economic status and later health and wellbeing［J］．BMC Public Health，2014，14（1）：1172.DOI：10.1186/1471-2458-14-1172.
［33］BROMBERGER J T，SCHOTT L，KRAVITZ H M，et al．Risk factors for major depression during midlife among a community sample of women with and without prior major depression：are they the same or different?［J］．Psychol Med，2015，45（8）：1653-1664.DOI：10.1017/S0033291714002773.
［34］BAREIS N，MEZUK B.The relationship between childhood poverty，military service，and later life depression among men：evidence from the Health and Retirement Study［J］．J Affect Disord，2016，206：1-7.DOI：10.1016/j.jad.2016.07.018.
［35］GILMAN S E，KAWACHI I，FITZMAURICE G M，et al．Socioeconomic status in childhood and the lifetime risk of major depression［J］．Int J Epidemiol，2002，31（2）：359-367.
［36］NIKULINA V，WIDOM C，CZAJA S.The role of childhood neglect and childhood poverty in predicting mental health，academic achievement and crime in adulthood［J］．Am J Community Psychol，2011，48（3/4）：309-321.DOI：10.1007/s10464-010-9385-y.
［37］ROMENS S E，MCDONALD J，SVAREN J，et al．Associations between early life stress and gene methylation in children［J］．Child Dev，2015，86（1）：303-309．DOI：10.1111/cdev.12270.
［38］SHEIKH M A，ABELSEN B，OLSEN J A.Differential recall bias，intermediate confounding，and mediation analysis in life course epidemiology：an analytic framework with empirical example［J］．Front Psychol，2016，7：1828.
［39］GREENFIELD E A，MOORMAN S M．Childhood socioeconomic status and later life cognition：evidence from the Wisconsin Longitudinal Study［J］．J Aging Health，2018：898264318783489．DOI：10.1177/0898264318783489.
［40］HORVAT P，RICHARDS M，MALYUTINA S，et al．Life course socioeconomic position and mid-late life cognitive function in eastern Europe［J］．J Gerontol B Psychol Sci Soc Sci，2014，69（3）：470-481．DOI：10.1093/geronb/gbu014.
［41］GONZáLEZ H M，TARRAF W，BOWEN M E，et al．What do parents have to do with my cognitive reserve? Life course perspectives on twelve-year cognitive decline［J］．Neuroepidemiology，2013，41（2）：101-109．DOI：10.1159/000350723.
［42］TOMALSKI P，JOHNSON M H.The effects of early adversity on the adult and developing brain［J］．Curr Opin Psychiatry，2010，23（3）：233-238．DOI：10.1097/YCO.0b013e3283387a8c.
［43］STAFF R T，MURRAY A D，AHEARN T S，et al．Childhood socioeconomic status and adult brain size：childhood socioeconomic status influences adult hippocampal size［J］．Ann Neurol，2012，71（5）：653-660．DOI：10.1002/ana.22631.
［44］LAITINEN T T，PUOLAKKA E，RUOHONEN S，et al．Association of socioeconomic status in childhood with left ventricular structure and diastolic function in adulthood：the cardiovascular risk in Young Finns Study［J］．JAMA Pediatr，2017，171（8）：781-787．DOI：10.1001/jamapediatrics.2017.1085.
［45］COHEN S，JANICKI-DEVERTS D，TURNER R，et al．Childhood socioeconomic status，telomere length，and susceptibility to upper respiratory infection［J］．Brain Behav Immun，2013，34：31-38.DOI：10.1016/j.bbi.2013.06.009.
［46］MATTHEWS K A，CHANG Y，BROMBERGER J T，et al．Childhood socioeconomic circumstances，inflammation，and hemostasis among midlife women：study of women's health across the nation［J］．Psychosom Med，2016，78（3）：311-318.DOI：10.1097/PSY.0000000000000283.
［47］JOHN-HENDERSON N，MARSLAND A L，KAMARCK T W，et al．Childhood socioeconomic status and the occurrence of recent negative life events as predictors of circulating and stimulated levels of interleukin-6［J］．Psychosom Med，2016，78（1）：91-101.DOI：10.1097/PSY.0000000000000262.
［48］HALFON N，HOCHSTEIN M.Life course health development：an integrated framework for developing health，policy，and research［J］．Milbank Q，2002，80（3）：433-479.
［49］NASTIS S A，CROCKER T D.Valuing mother and child health：the intrauterine environment［J］．Econ Hum Biol，2012，10（3）：318-328.DOI：10.1016/j.ehb.2011.03.003.
［50］HILL S，PROKOSCH M L，DELPRIORE D J，et al．Low childhood socioeconomic status promotes eating in the absence of energy need［J］．Psychol Sci，2016，27（3）：354-364.DOI：10.1177/0956797615621901.
［51］PUOLAKKA E，PAHKALA K，LAITINEN T T，et al．Childhood socioeconomic status in predicting metabolic syndrome and glucose abnormalities in adulthood：the cardiovascular risk in Young Finns Study［J］．Diabetes Care，2016，39（12）：2311-2317.
［52］PAVELA G.Is childhood socioeconomic status independently associated with adult BMI after accounting for adult and neighborhood socioeconomic status?［J］．PLoS One，2017，12（1）：e0168481.DOI：10.1371/journal.pone.0168481.
［53］BALDWIN J R，ARSENEAULT L，CASPI A，et al．Childhood victimization and inflammation in young adulthood：a genetically sensitive cohort study［J］．Brain Behav Immun，2018，67：211-217.DOI：10.1016/j.bbi.2017.08.025.
［54］GUSTAFSSON P E，ANCKARS?TER H，LICHTENSTEIN P，
et al．Does quantity have a quality all its own? Cumulative adversity and up- and down-regulation of circadian salivary cortisol levels in healthy children［J］．Psychoneuroendocrinology，2010，35（9）：1410-1415.DOI：10.1016/j.psyneuen.2010.04.004.
［55］WANG Q，SHEN J J.Childhood health status and adulthood cardiovascular disease morbidity in rural china：are they related?［J］．Int J Environ Res Public Health，2016，13（6）：565.DOI：10.3390/ijerph13060565.
［56］陆海霞，卢展民，王春美.生命历程方法在口腔流行病学中的应用［J］．国际口腔医学杂志，2013，40（3）：339-343.DOI：10.7518/gjkq.2013.03.017.
LU H X，LU Z M，WANG C M.Application of life course approach on oral epidemiology［J］．International Journal of Stomatology，2013，40（3）：339-343.DOI：10.7518/gjkq.2013.03.017.
［57］HERTZMAN C，POWER C，MATTHEWS S，et al．Using an interactive framework of society and life course to explain self-rated health in early adulthood［J］．Soc Sci Med，2001，53（12）：1575-1585.
［58］MCKENZIE S，CARTER K，BLAKELY T，et al．Effects of childhood socioeconomic position on subjective health and health behaviours in adulthood：how much is mediated by adult socioeconomic position?［J］．Journal of Epidemiology and Community Health，2011，65（suppl 1）：123.DOI：10.1186/1471-2458-11-269.
［59］LUO Y，WAITE L J.The impact of childhood and adult ses on physical，mental，and cognitive well-being in later life［J］．Journals of Gerontology，2005，60（2）：s93-101.
［60］POULTON R，CASPI A，MILNE B J，et al．Association between children's experience of socioeconomic disadvantage and adult health：a life-course study［J］．Lancet，2002，360（9346）：1640-1645.
［61］SYME S L，BORHANI N O，BUECHLEY R W.Cultural mobility and coronary heart disease in an urban area［J］．Am J Epidemiol，1965，82（3）：334.
［62］O'RAND A M，HAMIL-LUKER J.Processes of cumulative adversity：childhood disadvantage and increased risk of heart attack across the life course［J］．J Gerontol B Psychol Sci Soc Sci，2005，60（s2）：117-124.
［63］EVANS G W，KANTROWITZ E.Socioeconomic status and health：the potential role of environmental risk exposure［J］．Annu Rev Public Health，2002，23（1）：303-331.
［64］SHONKOFF J P，PHILLIPS D A.From neurons to neighborhoods：the science of early childhood development［M］．Washington，DC：National Academy Press，2000：124-162.
［65］FRATIGLIONI L，JORM A F，GRUT M，et al．Predicting dementia from the Mini-Mental State Examination in an elderly population：the role of education［J］．J Clin Epidemiol，1993，46（3）：281-287.
［66］李立明，吕筠.大型前瞻性人群队列研究进展［J］．中华流行病学杂志，2015，36（11）：1187-1189.DOI：10.3760/cma.j.issn.0254-6450.2015.11.001.
LI L M，LYU J.Large prospective cohort studies：a review and update［J］．Chinese Journal of Epidemiology，2015，36（11）：1187-1189.DOI：10.3760/cma.j.issn.0254-6450.2015.11.001.

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