Peer status in school and adult disease risk: a 30-year follow-up study of disease-specific morbidity in a Stockholm cohort
Peer status in school and adult disease risk: a 30-year follow-up study of disease-specific morbidity in a Stockholm cohort
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DOI：
10.1136/jech.2009.088377
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发表时间：
2009-12-01
影响因子：
6.3
通讯作者：
Almquist, Y.
中科院分区：
文献类型：
--
作者：
Almquist, Y.
背景：儿童除了家庭之外，还有自己的社会地位，这可能对短期和长期健康产生影响。本研究的目的是分析儿童在学校的社会地位（即同伴地位）与成年后特定疾病发病率之间的关系。方法：数据来源于一项纵向研究，使用1953年出生在瑞典斯德哥尔摩的队列：斯德哥尔摩出生队列研究（1953-2003）。同伴地位在六年级进行社会计量学评估（1966）。基于1973-2003年住院治疗信息的成人疾病特异性发病率的风险比分别用Cox回归计算了男性和女性的同伴地位类别。结果：儿童同伴地位越低，成人疾病总体风险越高。然而，特定疾病住院治疗的程度和幅度随同伴地位的不同而不同。在精神和行为障碍（如酗酒和药物依赖）、外部原因（如自杀）和各种与生活方式有关的疾病（如缺血性心脏病和糖尿病）方面，发现了一些最陡峭的梯度。这一结果不能用童年的社会阶层来解释。结论：目前的研究强调了认识到儿童的社会地位，除了他们的家庭地位，对以后的健康的重要性。不仅与心理有关的疾病，而且与行为风险因素有关的疾病也显示出同伴地位之间的一些最大相对差异，这表明与健康有关的行为可能是同伴地位与发病率之间关联的一个重要机制。
Background: Children have a social status position of their own, apart from that of the family, that may have an impact on short-term and long-term health. The aim of the present study was to analyse the associations between childhood social status in school (ie, peer status) and disease-specific morbidity in adulthood.Methods: Data were derived from a longitudinal study using a 1953 cohort born in Stockholm, Sweden: The Stockholm Birth Cohort Study (1953-2003). Peer status was sociometrically assessed in sixth grade (1966). Hazard ratios for adult disease-specific morbidity based on information on inpatient care (1973-2003) were calculated by peer status category for men and women separately, using Cox regression.Results: The results indicate that the lower the childhood peer status, the higher the overall adult disease risk. There were, however, differences in the degree and magnitude to which disease-specific inpatient care varied with peer status. Some of the steepest gradients were found for mental and behavioural disorders (eg, alcohol abuse and drug dependence), external causes (eg, suicide) and various lifestyle-related diseases (eg, ischaemic heart disease and diabetes). The results were not explained by childhood social class.Conclusion: The present study underlines the importance of recognising children's social position, apart from that of their family, for later health. Not only psychologically related diseases but also those related to behavioural risk factors demonstrate some of the largest relative differences by peer status, suggesting that health-related behaviour may be one important mechanism in the association between peer status and morbidity.