Processes of cumulative adversity: Childhood disadvantage and increased risk of heart attack across the life course
Processes of cumulative adversity: Childhood disadvantage and increased risk of heart attack across the life course
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DOI：
10.1093/geronb/60.special_issue_2.s117
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发表时间：
2005-10-01
影响因子：
6.2
通讯作者：
Hamil-Luker, J
中科院分区：
文献类型：
--
作者：
O'Rand, AM;Hamil-Luker, J
目标。这篇文章探讨了在整个生命过程中，累积逆境是如何塑造心脏病发作风险轨迹的。我们的样本包括出生于1931年至1941年之间的9760名健康与退休研究受访者。通过对被调查者早期背景的自我报告的回顾性测量，我们首先确定了三种具有不同童年劣势暴露的潜在类别。与受教育程度、就业状况、收入水平、婚姻史和健康行为相关的干预协变量被加入到逆境的顺序过程中。最后的潜在类聚类模型估计了这些协变量在1992年至2002年间对三种不同的心脏病发作风险轨迹的累积影响：高、增加和低。早期不利条件和儿童疾病会产生严重的持久影响，并增加心脏病发作的风险。然而，成人途径对心脏病发作风险轨迹的影响不同，并介导早期不利因素的影响。研究结果表明，未来的研究应考虑童年时期开始的累积逆境过程如何影响老年期的健康结果。
Objectives. This article examines how processes of cumulative adversity shape heart attack risk trajectories across the life course.Methods. Our sample includes 9760 Health and Retirement Study respondents born between 1931 and 1941. Using self-reported retrospective measures of respondents' early background, we first identify three latent classes with differential exposure to childhood disadvantage. Intervening covariates associated with educational attainment, employment status, income attainment, marital history, and health behaviors are added to capture sequential processes of adversity. Final latent-class cluster models estimate the cumulative impact of these covariates on three different heart attack risk trajectories between 1992 and 2002: high, increasing, and low.Results. Early disadvantage and childhood illness have severe enduring effects and increase the risk for heart attack. Adult pathways, however, differentially influence trajectories of heart attack risk and mediate the effects of early disadvantage.Discussion. Findings suggest that future research should consider how processes of cumulative adversity initiated in childhood influence health outcomes in older ages.