Mediation of the effect of childhood socioeconomic position by educational attainment on adult chronic disease in Chile
| Autor: | Patricia Frenz, Carolina Nazzal, Francisco Cerecera, Nicolás Silva, Jay S. Kaufman, Gabriel Cavada |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Mediation (statistics) Health (social science) Psychological intervention Young Adult 03 medical and health sciences 0302 clinical medicine Environmental health medicine Humans Social inequality Longitudinal Studies 030212 general & internal medicine Chile Child Aged Aged 80 and over 030505 public health business.industry Public health Public Health Environmental and Occupational Health Health Status Disparities Middle Aged Non-communicable disease medicine.disease Child development Educational attainment Health equity Social Class Chronic Disease Educational Status Female 0305 other medical science business |
| Zdroj: | International Journal of Public Health. 62:1007-1017 |
| ISSN: | 1661-8564 1661-8556 |
| DOI: | 10.1007/s00038-017-0996-z |
| Popis: | We estimated the roles of childhood socioeconomic position (ChSEP) and education attainment on chronic diseases in Chilean adults, mediated through structural determinants and health behaviors, to identify potential pro-equity interventions. We analyzed Chile’s longitudinal Social Protection Surveys, a national sample of 14,788 adults with follow-up to 2009. Controlled direct effects (CDE) and natural effects (NDE and NIE) of ChSEP and education on number of chronic diseases were estimated with negative binomial models. CDE of low ChSEP with education fixed at 12 years showed a 12% increase with 4% indirect effects. CDEs at favorable levels of BMI, smoking, alcohol use, and physical activity were similar. CDE estimates for education adjusted for ChSEP were larger with negligible mediation. CDEs for women were generally larger. Low ChSEP exerts a primarily direct effect on later chronic disease, modestly mediated by education. Education attainment showed larger direct effects with minimal mediation by behaviors. Strengthening current–early child development and education policies, particularly gender aspects, may reduce social inequalities and key pathways for reducing chronic disease inequalities in Chile. |
| Databáze: | OpenAIRE |
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