■妇女的健康和福祉(WHW)受到越来越多的关注,但是在如何衡量中低收入国家(LMICs)的不同领域方面取得了有限的进展。我们使用了来自巴西五个长期出生队列的数据,危地马拉,菲律宾和南非探索成人WHW的不同领域,以及这些领域如何与早期生命暴露相关。
■基于数据中可用的八个假定WHW结果的先验概念化,我们将它们分组如下:人力资本(智商,学校教育,高度,和青少年生育),代谢健康(体重指数和代谢综合征评分),和心理(幸福感和自我报告问卷(SRQ)得分)。相关分析证实,理论上属于WHW相同维度的变量在统计学上是相关的。然后,我们分别对每组变量应用主成分分析,并使用第一个主成分作为相应WHW维度的汇总定量度量。最后,我们评估了每个领域与一系列早期生活因素的关联:财富,母亲教育,产妇身高,水,和卫生,出生体重,两年的长度和童年中期的发育商。
■这三个域在很大程度上不相关。早期决定因素与人力资本呈正相关,而出生顺序呈负相关。发现代谢或心理成分的关联较少。出生体重和两岁时的体重与代谢健康呈负相关。母亲教育与更好的心理健康相关。
■我们的研究结果表明,WHW是多维的,队列中的大多数女性在一个或多个领域受到损害,而在所有三个领域中得分都很高的女性很少。我们的分析受到缺乏关于青少年暴露和其他相关WHW维度的数据的限制,如安全性,agency,赋权,和暴力。在LMICs中需要进一步研究以识别和测量WHW的多个域。
UNASSIGNED: Women\'s health and well-being (WHW) have been receiving growing attention, but limited progress has been made on how to measure its different domains in low- and middle-income countries (LMICs). We used data from five long-term birth cohorts in Brazil, Guatemala, the Philippines and South Africa to explore different domains of adult WHW, and how these domains relate to early life exposures.
UNASSIGNED: Based upon an a priori conceptualisation of eight postulated WHW outcomes available in the data, we grouped them as follows: human capital (intelligence quotient, schooling, height, and teenage childbearing), metabolic health (body mass index and metabolic syndrome score), and psychological (happiness and Self-Reported Questionnaire (SRQ) scores). Correlation analyses confirmed the variables theoretically belonging to the same dimension of WHW were statistically related. We then applied principal component analysis to each group of variables separately and used the first principal component as a summary quantitative measure of the corresponding WHW dimension. Finally, we assessed the association of each domain with a range of early-life factors: wealth, maternal education, maternal height, water, and sanitation, birthweight, length at two years and development quotient in mid-childhood.
UNASSIGNED: The three domains were largely uncorrelated. Early determinants were positively associated with human capital, while birth order was negatively associated. Fewer associations were found for the metabolic or psychological components. Birthweight and weight at age two years were inversely associated with metabolic health. Maternal education was associated with better psychological health.
UNASSIGNED: Our findings indicate that WHW is multidimensional, with most women in the cohorts being compromised in one or more domains while few women scored highly in all three domains. Our analyses are limited by lack of data on adolescent exposures and on other relevant WHW dimensions such as safety, agency, empowerment, and violence. Further research is needed in LMICs for identifying and measuring the multiple domains of WHW.