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幼児期と成人期における欠乏:どちらが死亡リスクにとってより重要か?
1Department of Epidemiology and Public Health, University College and Middlesex School of Medicine, UK.
Lancet (London, England)
|March 2, 1991
まとめ
早期の生活条件は,成人の心血管疾患に直接影響しないかもしれません. 幼児死亡率と成人死亡率の間の歴史的な関連を説明するのは,人生の初期に起こった出来事ではなく,社会経済的な要因であるようです.
科学分野:
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
- 健康の社会的決定因子
背景:
- 生態学的な研究は,幼少期の要因が成人期の心血管疾患や呼吸器疾患に影響を及ぼすことを示唆しています.
- 過去の幼児死亡率と現在の成人死亡率の間の地理的な相関が観察されています.
- 以前の研究では,持続的な社会経済的欠乏を適切にコントロールできなかったかもしれません.
研究 の 目的:
- 持続的な社会経済的状況が,早期の生命と成人死亡率との間の観察された関連を説明するという仮説を調査する.
- 現在の社会経済状態を考慮して,成人死亡リスクに対する初期の生活要因の影響を再評価する.
主な方法:
- 幼児死亡率 (1895年−1908年) と特定原因による成人死亡率 (1969年−1973年) の相関関係 イギリスとウェールズ (43郡).
- 現在の社会的欠乏と社会階級の指標に対する調整された相関.
- 65歳から74歳までの成人の死亡率データを分析した.
主要な成果:
- 幼児死亡率と成人死亡率との間に強い初期相関が認められた.
- これらの相関は,現在の社会経済的状況に調整した後に,著しく弱まり,または排除されました.
- この発見は,生命の初期における要因と成人における冠動脈疾患による死亡率との間の直接的な因果関係に疑問を投げかけている.
結論:
- 過去の乳児死亡率と現在の成人の死亡率との間の観察された関連は,持続的な社会経済的欠乏によって説明される可能性が高い.
- 以前の生態学的な研究は,成人時の心血管疾患に対する初期の人生の要因の直接的な影響を過大評価している可能性があります.
- これらの関係を明らかにするために,幼児期から成人期までの個人を追跡するさらなる縦断研究が必要です.
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