童年逆境与晚年慢性病发展轨迹

Childhood Adversity and Trajectory of Chronic Diseases in Later

生命早期风险因素为晚年慢性病发展埋下隐患。本文从生命历程角度出发,利用中国健康与养老追踪调查(CHARLS)2011年至2018年追踪调查数据,运用Logistic回归和分层Poisson回归,以慢性病为健康测量,探究了童年逆境与晚年慢性病动态转变与发展轨迹的关系。研究发现,童年逆境与慢性病患病风险显著相关,但是因慢性病的不同类型而异;早期“苦日子”带来的过度损耗类慢性病患病风险长期存在,而与过度摄取类慢性病无显著关联。童年时期遭受身体暴力、父母精神健康状况不佳和自评健康较差与晚年慢性病发展轨迹有显著相关性;随着年龄增长,慢性病发展轨迹在童年逆境群体与非童年逆境群体之间的差异逐渐扩大。

Early life risk factors lay the ground for later-life chronic disease development.From the life course perspective,this study examines the relationship between childhood adversity and the transition and trajectory of chronic diseases in later life using the China Health and Retirement Longitudinal Study(CHARLS)data from 2011 to 2018.The findings are as follows:Firstly,childhood adversity was significantly associated with the risk of chronic diseases but varied according to different chronic conditions.Secondly,childhood adversity was persistently associated with the risk of over-expenditure chronic diseases rather than the risk of over-take chronic diseases in later life.Third,physical abuse in childhood,poor parental mental health,and poorer self-rated childhood health were significantly associated with chronic disease trajectories in later life.Finally,the differences in chronic disease trajectories between individuals with and without early life“hard times"”increased with age.