Ohio State University, United States; The University of Hong Kong, China.
SUNY-Albany, United States.
Soc Sci Med. 2023 Nov;337:116282. doi: 10.1016/j.socscimed.2023.116282. Epub 2023 Oct 4.
Morbidity and mortality are on the rise among Americans from Boomers to Millennials. We investigate early-life diseases and the socioeconomic, psychosocial, and bio-behavioral factors behind this worsening health trend. Using data from the Panel Study of Income Dynamics Family and Individual Files 1968-2013, we find that the chronic disease index and poor subjective health have continuously increased for Baby Boomers and later cohorts. Early-life diseases, obesity, and shortening job tenure account for about half the health decline across cohorts. Weakening union protection, decreasing marriage, and declining religion only make minor contributions. All other factors, including early life nutrition and family background, adulthood socioeconomic status, physical activity, and smoking behaviors, make negative or non-significant contributions. These findings highlight that even though recent cohorts have better childhood nutrition, family socioeconomic environment,and higher levels of education and income, these advantages have been offset by elevated early-life disease exposure, obesity, and a precarious labor market. We discuss the findings in the context of Case and Deaton's "cumulative deprivation" thesis.
美国人的发病率和死亡率在婴儿潮一代到千禧一代中呈上升趋势。我们研究了导致这种健康状况恶化的早发性疾病以及背后的社会经济、心理社会和生物行为因素。利用 Panel Study of Income Dynamics Family and Individual Files 1968-2013 中的数据,我们发现,慢性疾病指数和较差的主观健康状况在婴儿潮一代及以后的几代人中持续增加。早发性疾病、肥胖和缩短的工作任期占各队列健康下降的一半左右。工会保护的削弱、结婚率的下降和宗教信仰的下降只产生了较小的影响。其他所有因素,包括儿童时期的营养和家庭背景、成年后的社会经济地位、体育活动和吸烟行为,都产生了负面或非显著的影响。这些发现表明,尽管最近几代人的儿童时期营养、家庭社会经济环境以及教育和收入水平都有所提高,但这些优势已被早发性疾病暴露、肥胖和不稳定的劳动力市场所抵消。我们在 Case 和 Deaton 的“累积剥夺”理论的背景下讨论了这些发现。