Socioeconomics Status&Respiratory/Cardiovascular Health

描述(申请人提供)：低社会经济地位(SES)对成年后的健康有很大的负面影响；然而，对SES如何影响儿童健康知之甚少。我们认为，在整个儿童期和青春期，SES的作用可能不是一致的，而是随着儿童经历不同的发展阶段，其强度可能会发生变化。记录从儿童早期到青春期后期的SES差异是很重要的，因为以前的研究经常基于广泛的年龄范围的儿童来调查儿童SES的影响。这种方法存在得出误导性结论的风险(例如，SES影响整个儿童的健康)，如果SES的影响实际上只归因于儿童的特定时期(例如，儿童早期，但不是青春期)。在这项研究中，我们建议通过分析两个大型的全国性数据集(1994年全国健康访谈调查和国家青少年纵向研究)来对年龄、SES和儿童健康之间的相互关系进行实证检验，这两个数据集包含关于SES和儿童呼吸系统(例如哮喘)和心血管健康结果的信息。通过这个二次数据分析，我们将检验SES与健康之间的关系随年龄而变化的假设，并遵循三种模式之一：持久性模型(SES对健康的持续影响从幼儿到青春期)；童年有限模型(SES对健康的影响在儿童早期很强，但随着时间的推移逐渐减弱)；或青少年涌现模型(SES影响在生命早期很小，但随着时间的推移逐渐增加)。这两个数据集将使我们能够从横向和纵向两个方面解决我们的假设。在纵向上，我们将能够解决以下问题：儿童早期的SES是否继续对儿童的健康产生持续的影响(不管后来家庭SES的改善如何)，以及家庭SES的某些模式(例如，持续贫困与波动的SES)是否与儿童年龄增长时的健康最密切相关。最后，鉴于样本量很大，我们还可以开始梳理出社会经济地位与种族对儿童健康的影响。这些分析可能会对如何安排干预措施的时间以减少儿童的健康差距，以及理解推动SES与儿童健康之间关系的中介因素具有一定的意义。

DESCRIPTION (provided by applicant): Low socioeconomic status (SES) has a strong negative impact on health in adulthood; however, very little is known about how SES impacts health during childhood. We propose that the effect of SES may not be consistent throughout all of childhood and adolescence, but rather, may change in strength as children pass through different stages of development. Documenting SES differences from early childhood through late adolescence is important because previous studies have often investigated childhood SES effects based on a wide age range of children. This approach runs the risk of drawing misleading conclusions (e.g., that SES impacts health across all of childhood) if in fact SES effects are attributable only to specific periods of childhood (e.g., early childhood but not adolescence). In the present study, we propose to conduct an empirical test of the interrelationships among age, SES and childhood health by analyzing two large, national datasets (National Health Interview Survey, 1994, and National Longitudinal Study of Youth- Children) that contain information about SES and childhood respiratory (e.g., asthma) and cardiovascular health outcomes. Through this secondary data analysis, we will test the hypothesis that the relationship between SES and health varies by age, and follows one of three patterns: Persistence model (constant effects of SES on health from early childhood through adolescence); Childhood limited model (SES effects on health that are strong in early childhood but decrease over time); or Adolescent emergent model (SES effects that are small early in life but gradually increase over time). The two datasets will allow us to address our hypotheses both cross-sectionally and longitudinally. Longitudinally, we will be able to address questions of whether early childhood SES continues to have a persistent effect on children's health (regardless of improvements in family SES later in life), and whether certain patterns of family SES (e.g., persistent poverty versus fluctuating SES) are most strongly associated with health as children age. Finally, given the large sample size, we can also begin to tease apart the effects of SES versus race on children's health. These analyses could have implications for how to time interventions to reduce health disparities in children, and for understanding the mediators that drive the relationship between SES and childhood health.