中老年人童年不良经历与健康状况的关联研究  

The association between adverse childhood experiences and health outcomes in middle-aged and elderly individuals

作　　者：何江泓 邝博咏 孙晓翠 易法令 HE Jianghong;KUANG Boyong;SUN Xiaocui;YI Faling(School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510006,China;Engineering and Technology Research Center of Guangdong Universities-Real World Engineering and Technology Research Center of Medical Information,Guangzhou 510006,China)

机构地区：[1]广东药科大学公共卫生学院,广东广州510006 [2]广东普通高校工程技术研究中心-医药信息真实世界工程技术研究中心,广东广州510006

出　　处：《广东药科大学学报》2024年第6期129-135,共7页Journal of Guangdong Pharmaceutical University

基　　金：广东省中医药管理局科研项目(20232090)。

摘　　要：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7319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、χ2检验及多因素非条件logistic回归分析。结果7319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%。7319名中老年人中,自评健康差者1880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2805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。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 7319 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 7319 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,1880(25.69%)rated their health as poor,282(3.85%)had impairments in Activities of Daily Living(ADL),and 2805(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.

关 键 词：中老年人群 童年不良经历 健康状况 风险因素 

分 类 号：R195[医药卫生—卫生统计学]