Journal of the American Board of Family Medicine : JABFM · 2013
Common illnesses, patient physician interactions, continuity, and practice organization.
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Shepherd Jonathan, Farrington David, Potts John
Аннотация
BACKGROUND: Antisocial lifestyle includes a range of related behaviours which constitute threats to health. Links between health outcomes and particular behaviours have been investigated, but the overall impact on health is largely unknown. In part, this reflects lack of longitudinal studies designed to link offending and other antisocial behaviour, injury and illness.
METHODS: Injury and illness data were collected prospectively in the longitudinal Cambridge Study of Delinquent Development (CSDD) for the age ranges 16-18 and 27-32. These data were translated into Read clinical codes, version 3.1 and categorized. Three hypotheses underpinned this investigation: that links between (i) convictions and injury and between (ii) childhood predictors of delinquency and injury at age 16-18 would be maintained at age 27-32; that (iii) antisocial behaviour at age 16-18 would be linked to injury at age 27-32; and that (iv) observed links between antisocial behaviour and decreased illness at age 16-18 would be reversed by age 27-32.
RESULTS: Childhood predictors of teenage offending predicted injury and cardiovascular and psychological illness at age 27-32. Delinquency predicted road, home and self injury and psychological disorder, but was associated with less illness and hospital admission. Measures of antisocial behaviour at age 18 which most strongly predicted illness/injury at age 32 were drunk driving, fighting after drinking, sexual promiscuity and heavy smoking. Relationships at age 16-18 between heavy alcohol consumption and less infection and less organic illness remained at age 27-32. Links common to both age 16-18 and age 27-32 were those between convictions, heavy regular drinking, low job status and injury; and links between convictions and less organic illness. Principal differences included links between convictions and psychological disorders only found at age 27-32.
CONCLUSIONS: Antisocial lifestyle was associated with injury and psychological disorders up to age 32 but also with less organic illness. Alcohol consumption at age 16-18 predicted fewer illnesses overall, and fewer infections 15 years later. These negative associations are important and deserve further study.
METHODS: Injury and illness data were collected prospectively in the longitudinal Cambridge Study of Delinquent Development (CSDD) for the age ranges 16-18 and 27-32. These data were translated into Read clinical codes, version 3.1 and categorized. Three hypotheses underpinned this investigation: that links between (i) convictions and injury and between (ii) childhood predictors of delinquency and injury at age 16-18 would be maintained at age 27-32; that (iii) antisocial behaviour at age 16-18 would be linked to injury at age 27-32; and that (iv) observed links between antisocial behaviour and decreased illness at age 16-18 would be reversed by age 27-32.
RESULTS: Childhood predictors of teenage offending predicted injury and cardiovascular and psychological illness at age 27-32. Delinquency predicted road, home and self injury and psychological disorder, but was associated with less illness and hospital admission. Measures of antisocial behaviour at age 18 which most strongly predicted illness/injury at age 32 were drunk driving, fighting after drinking, sexual promiscuity and heavy smoking. Relationships at age 16-18 between heavy alcohol consumption and less infection and less organic illness remained at age 27-32. Links common to both age 16-18 and age 27-32 were those between convictions, heavy regular drinking, low job status and injury; and links between convictions and less organic illness. Principal differences included links between convictions and psychological disorders only found at age 27-32.
CONCLUSIONS: Antisocial lifestyle was associated with injury and psychological disorders up to age 32 but also with less organic illness. Alcohol consumption at age 16-18 predicted fewer illnesses overall, and fewer infections 15 years later. These negative associations are important and deserve further study.