The contribution of childhood adversity to adult socioeconomic gradients in mortality: A Swedish birth cohort analysis

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-01-01 DOI:10.1016/j.socscimed.2024.117627

Josephine Jackisch , Alyson van Raalte

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引用次数: 0

Abstract

Background

“Child maltreatment is a leading cause of health inequality” according to a leading WHO report. This statement is often assumed, yet, the size of the contribution of childhood adversity to the adult socioeconomic gradient in mortality remains unknown. Inequalities in mortality have mostly been investigated by taking adult conditions as a starting point. The objective of this study is to quantify how much of the socioeconomic gradient in adult life expectancy is associated with childhood adversity.

Methods

Drawing on a 1953 birth cohort from Stockholm (n = 14 210), we compared inequalities in adult mortality within the full cohort to a counterfactual scenario where individuals with a history of childhood adversity (indicated by involvement with child welfare services) experienced the mortality rates of those achieving the same adult socioeconomic position, but with no history of childhood adversity. The socioeconomic gradient across education and income quintiles (attained by age 29) is measured by the slope index of inequality of temporary life expectancy (ages 29–67).

Results

The counterfactual scenario attenuated the education gradient by 40 percent for men and 54 percent for women. Similarly, inequalities by income were reduced in the counterfactual scenario by 49 percent for men and 47 percent for women.

Interpretation

These results support that childhood adversity is an important determinant of inequalities in mortality. The size of their contribution is equivalent to established behavioural risk factors. Taking a life course approach might provide important policy entry points to mitigate health inequalities.

查看原文本刊更多论文

童年逆境对成人社会经济死亡率梯度的贡献：瑞典出生队列分析。

背景：根据世卫组织的一份重要报告，“虐待儿童是卫生不平等的主要原因”。这种说法经常被假设，然而，童年逆境对成人死亡率的社会经济梯度的贡献大小仍然未知。对死亡率不平等现象的调查大多以成人状况为起点。本研究的目的是量化成人预期寿命的社会经济梯度与童年逆境的关系。方法：利用斯德哥尔摩1953年的出生队列（n = 14210），我们比较了整个队列中成人死亡率的不平等与一个反事实的情景，即有童年逆境史（通过参与儿童福利服务来表明）的个体经历了具有相同成年社会经济地位但没有童年逆境史的人的死亡率。教育和收入五分位数（29岁前达到的）的社会经济梯度通过临时预期寿命不平等的斜率指数（29-67岁）来衡量。结果：反事实情景使教育梯度在男性中降低了40%，在女性中降低了54%。同样，在反事实情景中，收入不平等在男性和女性中分别减少了49%和47%。解释：这些结果支持童年逆境是死亡率不平等的重要决定因素。他们的贡献大小相当于既定的行为风险因素。采取生命历程方法可能为减轻健康不平等提供重要的政策切入点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.