Table_1_Multi-State Analysis of the Impact of Childhood Starvation on the Healthy Life Expectancy of the Elderly in China.XLS

Background: Child malnutrition is not only common in developing countries but also an important issue faced by developed countries. This study aimed to explore the influence and degree of childhood starvation on the health of the elderly, which provides a reference for formulating health-related policies under the concept of full lifecycle health.
Methods: Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2008, 2011, and 2014, this study took a total of 13,185 elderly people aged 65–99 years as the target population. By IMaCH software, with gender and income level as the control variables, the average life expectancy and healthy life expectancy of the elderly were measured. The x2test was used to explore the differences in the socioeconomic status of elderly people with or without starvation in childhood. Statistical differences between average life expectancy and healthy life expectancy were analyzed by rank tests.
Results: (1) The results showed that there was a statistically significant difference in age, gender, residency, education level, and income level between the groups with or without starvation (P < 0.05). (2) Transition probabilities in health–disability, health–death, and disability–death all showed an upward trend with age (P < 0.05), where the elderly who experienced starvation in childhood were higher than those without such an experience (P < 0.05). However, the probability of disability–health recovery showed a downward trend with age (P < 0.05), in which the elderly who experienced starvation in childhood were lower than those without starvation (P < 0.05). (3) For the elderly who experienced starvation in childhood, the health indicators of the average life expectancy, healthy life expectancy, and healthy life expectancy proportion accounted for the remaining life were lower than those of the elderly without childhood starvation (P < 0.05).
Conclusions: The average life expectancy and healthy life expectancy of the elderly with childhood starvation are lower than those without childhood starvation. It shows that the negative impact of childhood starvation on health through the life course till old age has a persistent negative cumulative effect on the quantity and quality of life. Therefore, it is important to pay attention to the nutritional status of children in poor families from the perspective of social policymaking.

背景：儿童营养不良不仅在发展中国家普遍存在，亦是发达国家面临的重要公共卫生议题。本研究旨在探讨儿童期挨饿经历对老年健康的影响及其程度，为构建全生命周期健康理念下的卫生健康政策制定提供参考依据。方法：本研究基于2008年、2011年及2014年的中国老年健康与长寿追踪调查（Chinese Longitudinal Healthy Longevity Survey, CLHLS）数据，以共计13185名年龄介于65至99岁的老年人为研究对象。借助IMaCH软件，以性别与收入水平作为控制变量，测算老年人的平均预期寿命与健康预期寿命。采用卡方检验分析儿童期有挨饿经历与无挨饿经历老年人的社会经济状况差异，并通过秩和检验分析平均预期寿命与健康预期寿命的统计学差异。结果：(1) 研究显示，儿童期有挨饿经历与无挨饿经历的老年人群在年龄、性别、户籍、受教育水平及收入水平上均存在统计学显著性差异（P < 0.05）。(2) 健康-失能、健康-死亡及失能-死亡的转换概率均随年龄增长呈上升趋势（P < 0.05），且儿童期有挨饿经历的老年人该类概率高于无挨饿经历者（P < 0.05）。反之，失能-健康恢复的概率则随年龄增长呈下降趋势（P < 0.05），且儿童期有挨饿经历的老年人该概率低于无挨饿经历者（P < 0.05）。(3) 相较于儿童期无挨饿经历的老年人，儿童期有挨饿经历者的平均预期寿命、健康预期寿命及健康预期寿命占剩余寿命比例等健康指标均更低（P < 0.05）。结论：儿童期有挨饿经历的老年人平均预期寿命与健康预期寿命均低于无挨饿经历者。这表明儿童期挨饿经历对健康的负面影响会贯穿整个生命历程直至老年阶段，对生命数量与生命质量均存在持续性的负面累积效应。因此，从社会政策制定的视角出发，关注贫困家庭儿童的营养状况具有重要意义。