目的 探究我国中老年人童年不良经历(adverse childhood experiences,ACEs)发生情况及其与健康状况的关系,为更好理解ACEs的长期效应和制定更为全面的防控策略提供参考依据.方法 基于2014年和2020年中国健康与养老追踪调查(China health and retirement longitudinal survey,CHARLS)数据库,对7 319名45岁及以上受访者相关数据进行分析.运用Stata 16.0软件进行描述性分析、c2检验及多因素非条件logistic回归分析.结果 7 319名中老年人中,ACEs发生率为87.48%.有挨饿经历71.10%、家庭经济状况差37.89%、童年居住环境差36.36%、被欺凌16.03%、童年健康状况差11.97%、有孤独感11.67%、童年健康限制7.92%、童年社区不安全7.41%、家庭不完整0.82%.7 319名中老年人中,自评健康差者1 880名(25.69%),日常生活活动能力(activies of daily living,ADL)受损者282名(3.85%),有抑郁症状者2 805名(38.32%).多因素分析结果表明,现居住地为农村、家庭经济状况差、家庭不完整、童年居住环境差、童年健康状况差是自评健康差的危险因素;家庭经济状况差是ADL受损的危险因素;现居住地为农村、有挨饿经历、童年居住环境差、孤独感、被欺凌、童年健康状况差是抑郁症状的危险因素,婚姻状况是其保护因素(P<0.05).结论 我国中老年人中ACEs发生率较高且是影响中老年人健康的重要风险因素,其累积效应会进一步加剧中老年人面临的健康风险.
The association between adverse childhood experiences and health outcomes in middle-aged and elderly individuals
Objective To investigate the prevalence of Adverse Childhood Experiences(ACEs)among the middle-aged and elderly individuals in our country and to explore the relationship with health status,thereby providing a reference for better comprehension of the long-term effects of ACEs and the development of more comprehensive prevention and control strategies.Methods Based on the China Health and Retirement Longitudinal Survey(CHARLS)database in 2014 and 2020,relevant data of 7 319 respondents aged 45 years and older were analyzed.Descriptive analysis,c2 test,and multivariate unconditional logistic regression analysis were conducted using Stata 16.0 software.Results Among 7 319 middle-aged and older individuals,the prevalence of Adverse Childhood Experiences(ACEs)was 87.48%.71.10%experienced hunger,37.89%had poor family economic status,36.36%had poor childhood living environment,16.03%were bullied,11.97%had poor childhood health status,11.67%had loneliness,7.92%had health limitations in childhood,7.41%had unsafe childhood community and 0.82%had incomplete family.Within this group,1 880(25.69%)rated their health as poor,282(3.85%)had impairments in Activities of Daily Living(ADL),and 2 805(38.32%)exhibited depressive symptoms.Multivariate analysis results indicated that current rural residence,poor family economic status,family incompleteness,poor childhood living environment,and poor childhood health status were risk factors for poor self-rated health;poor family economic status was a risk factor for ADL impairment;current rural residence,experiencing hunger,poor childhood living environment,loneliness,bullying,and poor childhood health status were risk factors for depressive symptoms,while marital status served as a protective factor(P<0.05).Conclusion The incidence of ACEs is relatively high among the middle-aged and elderly individuals in China and represents a significant risk factor affecting their health.The cumulative effect of these experiences is likely to exacerbate the health risks faced by the elderly.
middle-aged and elderly individualsadverse childhood experienceshealth statusrisk factor
万方数据
维普
