家庭健康循环视角下的健康代际传递研究——基于CHNS 2015的实证分析

目的:基于家庭健康循环视角与家庭生态系统理论,探究健康状况、健康行为及健康认知的代际传递,为制定精准健康促进政策提供依据。方法:基于2015年CHNS数据,采用多分类Logistic、有序Logistic以及OLS模型探讨母亲主客观健康状况,健康行为及认知对子代主客观健康状况,健康行为及认知的影响。结果:母亲BMI显著影响子代BMI,母亲超重或肥胖,则子代超重、肥胖的相对风险高;母亲自评健康显著影响子代自评健康;母亲饮食得分与锻炼得分显著影响子代饮食得分与锻炼得分;母亲健康认知显著影响子代的健康认知。结论:健康状况、行为及认知均显著代际传递,建议开展亲子健康促进行动,并建设健康家庭环境。     

发展生态学理论视角下困境家庭儿童健康水平影响因素研究

目的:探究困境家庭儿童健康水平影响因素,为困境家庭儿童制定健康相应政策提供理论依据。方法:基于发展生态学理论框架,利用2018年8—9月开展的困境家庭儿童全国抽样调查数据,采用卡方检验和两独立样本T检验,分析困境家庭儿童和对照家庭儿童各指标差异,采用有序多分类Logistic回归进行多因素分析,采用倾向值匹配法分析社会救助政策对困境家庭儿童健康的影响。结果:困境家庭儿童与对照组儿童自评健康水平间差异具有统计学意义(P0.01)。基于发展生态学系统观,困境家庭儿童和对照组儿童各指标间差异具有统计学意义(P0.05)。年龄、民族、家庭人均年收入、监护人生活照顾、监护人沟通交流、一周吃新鲜水果次数、家庭是否重视学习、监护人受教育程度、是否接受社会救助补贴、规定接受国家疫苗接种是影响困境家庭儿童健康的因素(P0.05)。接受社会救助补贴对困境家庭儿童自评健康水平有显著正向促进作用(t2.576,P0.01)。结论和建议:家庭因素是困境家庭儿童健康水平重要影响因素,政策干预应当促进落实"家庭责任",重视困境家庭儿童社会保障工作,完善困境家庭儿童社会救助体系。     

海口市3~6岁学龄前儿童超重肥胖现状及影响因素分析△

目的：了解海口市学龄前儿童超重和肥胖现状及影响因素,为完善儿童超重肥胖防治措施提供依据。方法：于2022年6~12月,采用整群抽样的方法,选取海口市四个区10所幼儿园的738名3~6岁儿童,测量其身高与体重。并对其监护人进行问卷调查,采用SPSS 24.0进行χ2检验和多因素Logistic回归分析。结果：儿童性别、母亲文化程度、家庭人均月收入、水果摄入、静态活动时间是学龄前儿童超重肥胖的主要影响因素,差异具有统计学意义（P＜0.05）。结论：应针对相关影响因素进一步加强研究,完善防治措施以降低学龄前儿童超重肥胖率。     

儿童超重、肥胖的影响因素

儿童的超重、肥胖已成为世界性问题,严重影响儿童的身心健康.本文主要从遗传、家庭因素、运动以及社区食品供应等几方面对儿童超重、肥胖的影响因素进行综述.     

儿童饮食行为的可控性

儿童饮食行为问题仍是目前较为严重的公共卫生问题,由儿童不良饮食行为引起的超重肥胖现象依然严峻。儿童饮食行为受到遗传因素的影响相对较小,与父母健康素养、家庭环境、学校教育、社会文化等外在因素的关联更为密切。本文将从家庭、学校、社会等方面分析儿童饮食行为的可控性,为更好地促进儿童健康饮食行为提供科学依据。     

家庭相关因素与学龄期儿童青少年超重肥胖的相关性

目的探讨家庭相关因素与学龄期儿童青少年超重肥胖关系。方法选取2018年1月至2019年3月在本院就诊或健康体检的学龄期儿童青少年1 586例。以问卷调查方式收集儿童青少年及其父母的性别、年龄、家庭居住地、父母文化程度及家庭月收入情况,同时进行体格检查,测量身高和体重并计算体质量指数,根据相应标准分别判断6～12岁儿童、13～17岁儿童青少年及成年人的超重肥胖情况。结果 1 586例学龄期儿童青少年中检出超重129例(8.13%),肥胖98例(6.18%)。不同性别、年龄、地区、母亲体质量指数、父亲体质量指数、母亲文化程度、父亲文化程度及家庭人均月收入的学龄期儿童青少年中超重肥胖率差异均有统计学意义(均P0.05)。多因素Logistic回归分析显示,母亲体质量指数、父亲体质量指数、母亲文化程度及家庭人均月收入是学龄期儿童青少年超重肥胖的独立影响因素(均P0.05)。结论本地区学龄期儿童青少年超重肥胖率处于国内平均水平,应从父母亲体质量指数、母亲文化程度、家庭人均月收入3个方面加强对学龄期儿童青少年超重肥胖的防控。     

家庭健康促进视角下青少年抑郁的代际传递研究——基于CFPS2018的实证分析

目的：基于家庭健康促进视角,探究青少年抑郁的代际传递,为青少年心理健康促进提供理论和政策依据。方法：基于2018年CFPS数据,使用线性回归模型和Shapley值分解法分析父母抑郁水平对青少年抑郁水平的影响及其相对贡献度;利用中介和调节效应分析探讨父母日常关怀和家庭结构在抑郁代际传递中的作用机制。结果：父母抑郁水平显著影响青少年抑郁水平;亲子系统对青少年抑郁的相对贡献度最高;父母抑郁水平可通过青少年感知到的行踪关注来影响青少年抑郁水平;父母对青少年的学习和生活关怀可弱化父母抑郁对青少年抑郁的影响;与完整家庭相比,单亲家庭的抑郁代际传递效应更强。结论：青少年抑郁水平受其父母抑郁水平及所处家庭环境的影响,建议重视家庭心理健康建设,协同推进青少年心理健康促进与家庭教育形成政策合力。     

烟台市城区3~6岁儿童超重(肥胖)对体质健康影响分析

目的了解烟台市城区3~6岁儿童超重(肥胖)情况与体质状况,探索超重(肥胖)对儿童身体素质的影响,为改善学龄前儿童体质,防制儿童肥胖并促进其健康提供科学依据。方法多阶段整群抽取烟台市城区13所幼儿园3~6岁儿童795名,运用频数分析、χ^(2)检验、多因素logistic回归分析等统计检验方法,对超重(肥胖)分布、体质综合评价、超重(肥胖)对身体素质影响等进行分析。结果3~6岁儿童超重(肥胖)比例为34.33%,不同性别(P=0.001)、不同年龄(P=0.000)儿童超重(肥胖)发生率差异均有统计学意义;不同性别(P=0.000)、不同年龄(P=0.000)正常体重与超重(肥胖)儿童体质综合评价差异均有统计学意义;超重(肥胖)对儿童10 m折返跑(OR=0.836)、双脚连续跳(OR=0.824)有负向影响,对网球掷远(OR=1.245)有正向影响。结论烟台市城区3~6岁儿童超重(肥胖)比例较高,男童、5、6岁儿童是重点干预对象;相比正常体重儿童,不同性别、不同年龄的超重(肥胖)儿童体质综合评价均较差,超重(肥胖)女童、3岁超重(肥胖)儿童体质健康问题最为突出;超重(肥胖)儿童耐力素质和下肢力量较差,上肢力量较好。     

无锡市10～14岁儿童超重肥胖现状调查及影响因素分析

目的了解无锡市10～14岁儿童超重肥胖的流行现状,并探讨其影响因素。方法采用分层整群随机抽样方法,随机抽取无锡市3个地区的10～14岁儿童共2870人,进行问卷调查和体格检查。结果儿童超重检出率为11.39%(男生10.03%,女生1.36%),儿童肥胖检出率为2.23%(男生1.64%,女生0.59%),且男生超重和肥胖的检出率高于女生(P<0.01)。经多元线性回归分析表明,出生体重、父亲和母亲的BMI以及喜欢吃油炸食品为儿童期BMI的可能影响因素。结论无锡市10～14岁儿童超重和肥胖的流行情况处于中国富裕乡村和中小城市之间,控制超重向肥胖发展是一个重要的预防措施。出生体重、父亲和母亲的BMI以及喜欢吃油炸食品是儿童BMI的主要影响因素,提示应积极采取综合家庭干预的措施,预防儿童肥胖的发生及发展。     

深圳市盐田区6～18岁儿童单纯性肥胖症现状调查及影响因素分析

目的:了解深圳市盐田区6～18岁儿童单纯性肥胖症的流行现状及影响因素,为制定有效的防治措施提供科学依据。方法:按照随机整群抽样的方法抽取深圳市盐田区2 379例6～18岁儿童,测量其身高、体重,以WHO身高别体重标准作为超重和肥胖的判断标准;并对检出的肥胖儿童进行影响因素调查及多元逐步回归分析。结果:深圳市盐田区6～18岁儿童超重检出率为16.22%,肥胖检出率为14.80%;男童肥胖检出率明显高于女童(χ2=40.22,P<0.01);肥胖检出率在6～11岁有随年龄增高而迅速上升趋势,而11岁以后有随年龄增高而缓慢下降的趋势。儿童肥胖的主要影响因素包括4个月前人工喂养为主、食欲好、吃饭速度快、喜食西式快餐、经常一边看电视一边吃零食、经常看和食品有关的广告、小儿每天运动时间<1 h、父亲肥胖、母亲肥胖、父母双方肥胖以及母亲文化程度低。结论:深圳市盐田区6～18岁儿童超重及肥胖发生率较高,遗传、饮食行为和运动是儿童肥胖的主要影响因素,应采取家庭干预和群体干预的综合防治措施。     

Utilization of health‐care services by young children: The aftermath of the Turkish Health Transformation Program

The Turkish Health Transformation Program, initiated in 2003, has identified achieving universal access to health care as 1 of its main tenets. To date, substantial progress has been made toward universal health coverage. Service utilization statistics display an upward trend. In this study, we use official and nationally representative microdata collected by the Turkish Health Research Surveys to examine young children's (ages 0‐5) utilization of health services. Children in this age group deserve special attention because adverse health conditions in early childhood are known to have long‐time consequences. Policy makers regularly monitor statistics such as infant mortality rate and under‐5 mortality rate. We conduct logistic regression analyses to explain the probabilities of being taken to a health institution, to a dentist, and being included in the newborn screening program. We use a rich set of explanatory variables that represent the socioeconomic status (SES) of the child's household. Contrary to our expectations and to the goals of universal health coverage is SES indicators such as the insurance ownership of the parent matter for utilization. Decomposition analyses confirm these findings and reveal that the increase in utilization should have been higher than observed. Children from low SES households should be given special attention and that research efforts should focus on identifying the barriers that still hinder children's utilization of health‐care services.     

Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study

Background This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. Methods Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36‐Item Short Form Health Survey (SF‐36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self‐report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. Results This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. Conclusions This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self‐report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow‐up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.     

困境家庭儿童亲社会行为影响因素、作用与边际效应分析

目的：探讨困境家庭儿童亲社会行为的影响因素、作用并进行边际效应分析，为家庭、政府、社会有针对性实施促进困境家庭儿童亲社会行为的干预措施提供实证依据。方法：利用“困境家庭儿童健康调查”（2018年）数据，基于社会生态学理论，使用列联分析和卡方检验考察困境家庭儿童和普通家庭儿童亲社会行为的差异；运用有序多分类logistic回归分析环境变量对儿童亲社会行为的影响，采用边际效应分析不同层面的环境因素对困境家庭儿童亲社会行为不同等级的影响。结果：困境家庭儿童更易产生较差的亲社会行为；其认知能力、监护人的养育行为与生活照料的缺失以及朋友质量等因素对亲社会行为的发展产生重要影响；就影响因素作用看，监护人与儿童的沟通情况和朋友质量会加大困境家庭儿童和普通家庭儿童亲社会行为的差异；就亲社会行为处于不同程度的边际效应看，学习成绩优秀、监护人为其提供较好生活照顾、监护人经常与其沟通的困境家庭儿童亲社会行为处于正常范围的概率显著提高，监护人在过去一年打过儿童、朋友质量差的困境家庭儿童亲社会行为处于临界值和异常范围的概率显著增加。结论：社会生态系统中儿童子系统、父母子系统、儿童环境子系统都在不同程度上作用于儿童特别是困境家庭儿童的亲社会行为，政策干预应当综合造成个体行为异质性的各种环境因素，重视困境家庭儿童的心理建设和社会化发展。     

子女收入、家庭支持与老年人健康

目的：分析子女收入对老年人健康状况的影响及群体性差异,并探究家庭支持在其中的中介效果。方法：使用2011—2018年四期中国健康与养老追踪调查(CHARLS)数据构建非平衡面板,以60岁及以上老年人作为研究对象,基于时间固定效应模型分析子女收入对老年人健康的效应水平,使用倾向得分匹配法对内生性问题进行讨论,并采用Karlson-Holm-Breen(KHB)方法对子女经济转移、时间转移以及二者组合路径的家庭支持方式进行机制检验。结果：子女收入提高分别在0.049和0.033水平上显著改善老年人自评健康和生活满意度,在修正选择性偏差后结论依旧稳健;子女提供经济支持、照料与情感支持在改善老年人健康中发挥重要的中介作用。结论：子女收入对老年人存在健康溢出效应,但在不同年龄、性别和户籍状况老年群体中存在差异;提高青年收入水平,倡导子女提供兼顾经济和时间转移的家庭支持方式有利于改善老年人健康状况,有助于实现健康老龄化战略目标。     

Perceived instrumental support and children's health across the early life course

A large, venerable literature demonstrates the importance of social relationships and social support for health, though much less research examines whether the benefits of social support to mothers extend to children. This paper examines the relationship between mothers' perceptions of instrumental support and children's health using longitudinal data from the U.S. Fragile Families and Child Wellbeing Study (N = 4342), a cohort of American children born in urban areas to mostly unmarried parents. Results suggest mothers' perceptions of instrumental support is positively associated with children's overall health, and this finding persists despite controlling for a host of individual-level characteristics of mothers and children (including a lagged indicator of children's health) and in fixed-effect models. Mothers' economic security and mothers' wellbeing attenuate some, but not all, of the association between perceived instrumental support and children's overall health. In addition, the link between perceived instrumental support and three specific indicators of health – asthma, overweight/obese, and number of emergency room visits – falls to statistical insignificance after accounting for individual-level characteristics, suggesting these associations result from social selection processes. Taken together, these findings suggest the beneficial health consequences of social support may extend to children across the early life course and demonstrate the need to better understand mothers' reports of children's overall health.     

THE DYNAMICS OF INCOME‐RELATED HEALTH INEQUALITY AMONG AMERICAN CHILDREN

We estimate and decompose income‐related inequality in child health in the USA and analyze its dynamics using the recently introduced health mobility index. Data come from the 1997, 2002, and 2007 waves of the Child Development Supplement of the Panel Study of Income Dynamics. The findings show that income‐related child health inequality remains stable as children grow up and enter adolescence. The main factor underlying income‐related child health inequality is income itself, although other factors, such as maternal education, also play a role. Decomposition of income‐related health mobility indicates that health changes over time are more favorable to children with lower initial family incomes versus children with higher initial family incomes. However, offsetting this effect, our findings also suggest that changes in income ranking over time are positively related to children's subsequent health status. Copyright © 2012 John Wiley & Sons, Ltd.     

Women at risk: Gender inequality and maternal health

Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15–49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women’s exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women’s active participation in decisions about their own health during pregnancy and delivery.     

社区居家养老意愿下居住方式和子女支持对老年人基层卫生服务需求的影响

目的:探讨居住方式和子女支持对老年人基层卫生服务需求的影响,使基层卫生服务更具针对性,以满足不同居家类型老年人的卫生服务需求.方法:利用2016年中国老年社会追踪调查数据,采用负二项Hurdle回归模型(NBH模型)分析.结果:与子女同住会显著提高城乡居家老年人对基层卫生服务的需求(P<0.05),子女经济支持则会显著...     

Maternal general health and children's cognitive development and behaviour in the early years: findings from the Millennium Cohort Study

Background Mothers often experience physical and psychological difficulties during the post‐natal period and these may continue through the early years of raising children and have negative effects on engagement and caregiving. Pathways between maternal depression, parental engagement and caregiving and children's subsequent development have been described in longitudinal studies; yet, less is known about how other aspects of maternal health may influence children's development. Methods A longitudinal analysis within the Millennium Cohort Study was conducted including 7906 families from England. Maternal general health and psychological well‐being were assessed when their children were 9 months and 3 years old, socio‐demographic characteristics were assessed at 9 months, and engagement and caregiving were assessed at 3 years. These were examined as predictors of children's learning and development and behaviour at age 5. Results There are clear associations between maternal general health and children's development with regard to both learning and development and behaviour. These effects are reduced if psychological distress is taken into account; yet, maternal general health maintains importance as a predictor for children's subsequent development. There is evidence of an association via engagement and caregiving which links maternal health to children's development and evidence of the influence of underlying socio‐demographic disadvantage. Conclusion General maternal health as well as psychological well‐being during the early years of raising children may be influential for children's development. This study suggests the need for a broader recognition of maternal health as well as psychological well‐being as a foundation for family well‐being, and speaks to support for mothers in maintaining engagement and caregiving for their children during periods of ill health.