Childhood health and educational disadvantage are associated with adult multimorbidity in the global south: findings from a cross-sectional analysis of nationally representative surveys in India and Brazil.
Childhood health and educational disadvantage are associated with adult multimorbidity in the global south: findings from a cross-sectional analysis of nationally representative surveys in India and Brazil.
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DOI：
10.1136/jech-2022-219507
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发表时间：
2023-10
影响因子：
6.3
通讯作者：
Mercer, Stewart W.
中科院分区：
文献类型：
--
作者：
Pati, Sanghamitra;Sinha, Abhinav;Verma, Priyanka;Kshatri, Jayasingh;Kanungo, Srikanta;Sahoo, Krushna Chandra;Mahapatra, Pranab;Pati, Sandipana;Delpino, Felipe Mendes;Krolow, Andria;Teixeira, Doralice Severo da Cruz;Batista, Sandro;Nunes, Bruno P.;Weller, David;Mercer, Stewart W.
在印度和巴西等低/中等收入国家（LMICs），多次死亡已成为一项重大的医疗保健挑战。生命过程流行病学表明，生命早期的不良事件有助于个人成年后的健康。然而，很少有人知道的影响，早期生活的健康和社会因素的发展，在成年期的多发性硬化症在中低收入国家。我们的目的是探讨成人多发性硬化症与儿童健康和社会劣势之间的两个低收入国家，印度和巴西的关联。我们使用2017-2018年印度纵向老龄化研究（n=51 481）和2015-2016年“Estudo Longitudinal da Saude e Bem-Estar dos Idosos Brasileirous”（n=8730）的全国代表性调查对年龄≥50岁的老年人进行了二次数据分析。我们估计了多发性骨髓瘤的患病率，沿着95% CI作为所有加权比例的不确定性指标。采用广义线性模型中的对数链接来评估儿童健康与多发病不利因素之间的关系，报告为校正的患病率比（APR）。印度和巴西的多发性骨髓瘤患病率分别为25.53%和55.24%。在这两个国家中，认为自己的儿童健康状况不佳并因疾病而缺课一个月或更长时间的参与者的多发病率最高。在调整年龄和性别后，成人多发性硬化症和儿童健康状况不佳之间存在显著关联。（APR：（印度：1.38，1.16至1.65）和（巴西：1.19，1.09至1.30））;因病缺课一个月（AOR：（印度：1.73，1.49至2.01）和（巴西：1.16，1.08至1.25））。早期生活中的健康、教育和经济不利因素与成年多发病有关，似乎有助于以后的生活。在低收入国家，预防成年期多发病的生命过程方法可能有助于卫生方案和政策。
Multimorbidity has emerged as a major healthcare challenge in low/middle-income countries (LMICs) such as India and Brazil. Life course epidemiology suggests that adverse events in early life contribute to an individual’s later health in adulthood. However, little is known about the influence of early life health and social factors on the development of multimorbidity in adulthood in LMICs. We aimed to explore the association of adult multimorbidity with childhood health and social disadvantages among two LMICs, India and Brazil. We conducted a secondary data analysis of older adults aged ≥50 years using nationally representative surveys from Longitudinal Ageing Study in India, 2017–2018 (n=51 481) and ‘Estudo Longitudinal da Saude e Bem-Estar dos Idosos Brasileirous’, 2015–2016 (n=8730). We estimated the prevalence of multimorbidity along with 95% CI as a measure of uncertainty for all weighted proportions. Log link in generalised linear model was used to assess the association between childhood health and disadvantages with multimorbidity, reported as adjusted prevalence ratio (APR). The prevalence of multimorbidity was 25.53% and 55.24% in India and Brazil, respectively. Participants who perceived their childhood health as poor and missed school for a month or more due to illness had the highest level of multimorbidity across both countries. After adjusting for age and gender, a significant association between adult multimorbidity and poor self-rated childhood health (APR: (India: 1.38, 1.16 to 1.65) and (Brazil: 1.19, 1.09 to 1.30)); and missed school for a month due to illness (AOR: (India: 1.73, 1.49 to 2.01) and (Brazil: 1.16, 1.08 to 1.25)) was observed. Early life health, educational and economic disadvantages are associated with adult multimorbidity and appear to contribute to the later course of life. A life course approach to the prevention of multimorbidity in adulthood in LMICs may be useful in health programmes and policies.
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DOI：
10.1016/s0140-6736(16)31389-7
发表时间：
2017-01-07
期刊：
Lancet (London, England)
影响因子：
--
作者：
Black MM;Walker SP;Fernald LCH;Andersen CT;DiGirolamo AM;Lu C;McCoy DC;Fink G;Shawar YR;Shiffman J;Devercelli AE;Wodon QT;Vargas-Barón E;Grantham-McGregor S;Lancet Early Childhood Development Series Steering Committee
通讯作者：
Lancet Early Childhood Development Series Steering Committee
影响因子：
10.4
作者：
Osmond C;Barker DJ
通讯作者：
Barker DJ
影响因子：
4.7
作者：
Griffiths, P;Bentley, M
通讯作者：
Bentley, M
DOI：
10.1093/geronb/60.special_issue_2.s117
发表时间：
2005-10-01
影响因子：
6.2
作者：
O'Rand, AM;Hamil-Luker, J
通讯作者：
Hamil-Luker, J
DOI：
10.11606/s1518-8787.2018052000637
发表时间：
2018-01-01
期刊：
Revista de Saúde Pública
影响因子：
--
作者：
Nunes, Bruno Pereira;Batista, Sandro Rogério Rodrigues;Facchini, Luiz Augusto
通讯作者：
Facchini, Luiz Augusto