Enduring Effects of Early Adversity on Adult Health?

描述（由申请人提供）：一项新兴的研究将早期生活事件和经历与成年期和以后生活的结果联系起来，正在改变成人健康的研究。这项研究的总体目标是建立在生命过程的流行病学模型上，以解释多种形式的早期逆境损害健康的机制。先前的研究已经证明了早期逆境在生命历程中的重要性，但相对而言，很少有人关注可能影响身心过程的自我情境和反射方面。提出的研究借鉴累积不平等理论，以检验社会心理和社会经济资源在调解多重童年逆境与成人健康之间的关系中所起的作用。这项研究的数据来自美国中年发展全国调查（MIDUS）的两波。1995年，MIDUS调查了3,034名成年人（25-74岁），2005年对2,257名受访者进行了再次访谈，提供了十年的观察和机会，以观察发病率、残疾和自我报告的健康状况的变化，以及感知生活轨迹的改变。本研究有三个具体目的：1。确定哪些早期逆境对成人健康影响最大，并阐明与早期逆境相关的积累过程。2. 研究资源和对生活轨迹的认知在多大程度上调解了童年逆境与成人健康之间的关系。3. 考虑对生活轨迹的更积极的看法是否会降低波浪之间健康下降的速度，并抵消早期劣势的有害影响。从上述目标得出的假设将通过各种多元分析技术进行检验，以估计早期逆境对成人健康的直接和间接影响，并进行正式的中介测试。公共卫生相关性：本研究试图解释儿童时期的状况如何影响成年期的健康状况。澄清早期不利条件与成年疾病之间的联系将有助于制定有效战略，减少后代的健康问题。随着医疗政策制定者继续寻找负担得起的成本控制策略，从生命历程的角度理解成人健康和疾病变得越来越重要。

DESCRIPTION (provided by applicant): The study of adult health is being transformed by an emerging body of research linking early- life events and experiences with outcomes in adulthood and later life. The overall aim of this research is to build upon epidemiologic models of the life course to explicate the mechanisms by which multiple forms of early adversity compromise health. Previous research has demonstrated the gravity of early adversity on the life course, but relatively little attention has been given to the situational and reflexive aspects of the self that may shape psychosomatic processes. The proposed research draws upon cumulative inequality theory to examine the role that psychosocial and socioeconomic resources play in mediating the relationship between multiple childhood adversities and adult health. Data for this study come from two waves of the National Survey of Midlife Development in the United States (MIDUS). MIDUS surveyed 3,034 adults (ages 25-74) in 1995, and 2,257 respondents were re-interviewed in 2005, providing a decade of observation and the opportunity to observe incident morbidity, change in disability and self-reported health, and the modification of perceived life trajectories. This study has three specific aims: 1. To identify which early adversities are most consequential to adult health and explicate the accumulation processes associated with early adversity. 2. To examine the extent to which resources and perceptions of life trajectories mediate the relationship between childhood adversity and adult health. 3. To consider whether more positive perceptions of life trajectories reduce the rate of health decline between waves and counteract the noxious effects of early disadvantage. The hypotheses, derived from the above aims, will be tested with a variety of multivariate analytic techniques to estimate direct and indirect effects of early adversity on adult health, with formal tests of mediation. PUBLIC HEALTH RELEVANCE: This research attempts to explicate how childhood conditions shape health conditions during adulthood. Clarifying the link between early disadvantage and adult disease will enable development of effective strategies to reduce health problems for future generations. As healthcare policymakers continue to search for affordable cost- containment strategies, it is becoming increasingly important to understand adult health and illness in a life course perspective.