童年因素与非自然死亡有关,直到中年成人
Kimberly B Roth1, Geoffrey Kahn2, Carla L Storr3
1Department of Community Medicine, Mercer University School of Medicine, Savannah, Georgia.
JAMA network open
|February 23, 2024
概括
童年社区贫困,而不是个人因素,显著增加了成年人非自然死亡的风险. 经济政策对于解决健康差距和提高预期寿命至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 社会学 社会学 社会学
背景情况:
- 美国的预期寿命正在下降,成本不断上升,并遭受非自然死亡.
- 解决贫困地区童年因素对于扭转这一趋势至关重要.
研究的目的:
- 通过中年期确定与非自然死亡相关的童年因素.
- 为旨在减少过早死亡率的政策提供信息.
主要方法:
- 对巴尔的摩市公立学校 (1985-1986) 的儿童进行了纵向队列研究.
- 通过国家死亡指数到2020年进行跟踪,以确定非自然死亡 (无意伤害,自杀,杀人).
- 多变量考克斯比例危险模型分析了个人,家庭和社区因素.
主要成果:
- 没有个人 (例如,抑郁症,物质使用) 或家庭因素与非自然死亡有显著的关联.
- 女性性别与非自然死亡风险降低有关 (HR,0.13;95% CI,0.08-0.22).
- 儿童时期较高的社区公共援助率与非自然死亡风险的增加显著相关 (HR, 1.89; 95% CI, 1.09-3.30).
结论:
- 童年早期的邻居贫困是成年早期非自然死亡的重要预测因素.
- 没有确定个人和家庭层面可修改的风险因素.
- 针对社区贫困的经济政策对于推进健康平等和减少过早死亡率至关重要.
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