THE IMPACT OF CHILDHOOD LIVING-CONDITIONS ON ILLNESS AND MORTALITY IN ADULTHOOD
THE IMPACT OF CHILDHOOD LIVING-CONDITIONS ON ILLNESS AND MORTALITY IN ADULTHOOD
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DOI：
10.1016/0277-9536(93)90122-k
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发表时间：
1993-04-01
影响因子：
5.4
通讯作者：
LUNDBERG, O
中科院分区：
文献类型：
--
作者：
LUNDBERG, O
目的是探讨儿童时期的经济和社会问题指标与成年期的疾病和死亡率之间的关系，1968年，对1906-1951年出生的瑞典人口进行了抽样调查，了解他们的童年生活条件等情况。其中包括四项不良儿童生活条件指标。其中两项反映了经济状况（经济困难;大家庭，定义为四个或四个以上兄弟姐妹），两项反映了社会状况（家庭破裂;家庭冲突）。13年后的1981年，这个样本被重新采访。这使得1981年的疾病与1968年的儿童状况报告有关。还对1981-1984年期间的死亡率进行了跟踪调查，当对年龄、性别和父亲的社会阶层进行控制时，发现那些在童年时期面临经济和社会问题的人，成年后患病的风险要高得多。在所分析的四个因素中，抚养期间的家庭冲突与以后生活中的疾病以及死亡率关系最密切。家庭破裂，以及在某种程度上，童年时期的经济困难，也显然与以后的生活中的疾病有关。当所有四个因素同时包括在模型中时，这些结果也是正确的，并且在1968年控制精神疾病时保持相对不变。整个童年时期（即到16岁）似乎对瑞典的成人健康非常重要，在这一时期的生活中，社会问题似乎比经济问题更重要。这些研究结果进行了讨论，根据当代文献所暗示的更多的生物学机制。对潜在机制提出了两种假设，即（1）生物学上增加的对由儿童问题直接引起的疾病的易感性和（2）由儿童条件引发的不健康的生活生涯，其中增加的疾病风险是几个健康损害因素的总和。它的结论是，这里提出的研究结果提供更多的支持，这些假设的第二个。
The aim was to explore the relationships between indicators of economic and social problems in childhood on the one hand and illness and mortality in adulthood on the other.In 1968 a representative sample of the Swedish population born 1906-1951 were interviewed about their childhood living conditions, among other things. Four indicators of adverse childhood living conditions were included. Two of these reflect economic circumstances (economic hardship; a large family, defined as four or more siblings), and two reflect social conditions (broken family; conflicts in the family). In 1981, 13 years later, this sample was re-interviewed. This allows for illness in 1981 to be related to reports of childhood conditions given in 1968. A follow-up of mortality for the period 1981-1984 was also conducted.When one controls for age, sex and father's social class, those exposed to economic as well as social problems during childhood are found to have a considerably higher risk of being ill as adults. Of the four factors analysed, conflicts in the family during upbringing is that most strongly related to illness later in life, as well as with mortality. Having a broken family, and, to some extent, economic hardship during childhood, are also clearly associated with illness later in life. These results also hold true when all four factors are included simultaneously in the model, and remain relatively unchanged when controlling for mental illness in 1968.The childhood period as a whole (i.e. to the age of 16) seems to be quite important for adult health in Sweden, and social problems during this period of life seem to be more important in this respect than economic ones. These findings are discussed in the light of the more biological mechanisms implied by the contemporary literature. Two hypotheses for the underlying mechanisms are suggested, namely (1) a biologically increased susceptibility to illness caused directly by childhood problems and (2) unhealthy life careers triggered by childhood conditions, where the increased illness risk is the sum of several health-damaging factors. It is concluded that the findings presented here lend more support to the second of these hypotheses.