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La privación en la infancia o en la vida adulta: ¿qué es más importante para el riesgo de mortalidad?
1Department of Epidemiology and Public Health, University College and Middlesex School of Medicine, UK.
Lancet (London, England)
|March 2, 1991
Resumen
Las condiciones de la vida temprana pueden no tener un impacto directo en las enfermedades cardiovasculares adultas. Los factores socioeconómicos, no los eventos de la vida temprana, parecen explicar los vínculos históricos entre las tasas de mortalidad infantil y adulta.
Área de la Ciencia:
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
- Determinantes sociales de la salud.
Sus antecedentes:
- Los estudios ecológicos sugieren que los factores de la vida temprana influyen en las enfermedades cardiovasculares y respiratorias adultas.
- Se han observado correlaciones geográficas entre las tasas de mortalidad infantil del pasado y las tasas de mortalidad de adultos actuales.
- Las investigaciones anteriores pueden no haber controlado adecuadamente la privación socioeconómica persistente.
Objetivo del estudio:
- Investigar la hipótesis de que las circunstancias socioeconómicas persistentes explican el vínculo observado entre la vida temprana y la mortalidad adulta.
- Reevaluar la influencia de los factores de la vida temprana en el riesgo de mortalidad en adultos, teniendo en cuenta el estado socioeconómico actual.
Principales métodos:
- Las tasas de mortalidad infantil correlacionadas (1895-1908) con la mortalidad adulta por causa específica (1969-73) en Inglaterra y Gales (43 condados).
- Correlaciones ajustadas para los índices actuales de privación social y clase social.
- Se analizaron los datos de mortalidad de adultos de 65 a 74 años.
Principales resultados:
- Se encontraron fuertes correlaciones iniciales entre la mortalidad infantil temprana y la mortalidad adulta posterior.
- Estas correlaciones se atenuaron o eliminaron significativamente después de ajustarse a las circunstancias socioeconómicas actuales.
- Los hallazgos cuestionan un vínculo causal directo entre los factores de la vida temprana y la mortalidad por enfermedad coronaria en adultos.
Conclusiones:
- La asociación observada entre la mortalidad infantil en el pasado y la mortalidad adulta actual probablemente se explique por la privación socioeconómica persistente.
- Estudios ecológicos previos pueden sobreestimar el impacto directo de los factores de la vida temprana en la enfermedad cardiovascular en adultos.
- Se necesitan más estudios longitudinales que rastreen a los individuos desde la infancia hasta la edad adulta para aclarar estas relaciones.
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