Despite overall improvements in health and living standards in the Western world, health and social disadvantages persist across generations. Using nationwide administrative databases linked for 2.1 million Danish citizens, we leveraged a three-generation approach to test whether multiple, different health and social disadvantages—poor physical health, poor mental health, social welfare dependency, criminal offending, and Child Protective Services involvement—were transmitted within families and whether education disrupted these statistical associations. Health and social disadvantages concentrated, aggregated, and accumulated within a small, high-need segment of families: Adults who relied disproportionately on multiple, different health and social services tended to have parents who relied disproportionately on multiple, different health and social services and tended to have children who evidenced risk for disadvantage at an early age, through appearance in protective services records. Intra- and intergenerational comparisons were consistent with the possibility that education disrupted this transmission. Within families, siblings who obtained more education were at a reduced risk for later-life disadvantage compared with their cosiblings who obtained less education, despite shared family background. Supporting the education potential of the most vulnerable citizens might mitigate the multigenerational transmission of multiple disadvantages and reduce health and social disparities.

尽管西方世界的健康和生活水平总体上有所改善，但健康和社会劣势仍会代代相传。使用与 210 万丹麦公民关联的全国性行政数据库，我们利用三代方法来测试是否存在多种不同的健康和社会劣势——身体健康状况不佳、心理健康状况不佳、社会福利依赖、刑事犯罪和儿童保护服务参与——是在家庭中传播的，以及教育是否破坏了这些统计关联。健康和社会劣势集中、聚集和累积在一小部分高需求家庭中：过度依赖多种不同健康和社会服务的成年人往往有过度依赖多种、不同的卫生和社会服务，并且往往通过出现在保护服务记录中的孩子在很小的时候就证明了处于不利地位的风险。代内和代际比较与教育破坏这种传播的可能性是一致的。在家庭中，尽管有共同的家庭背景，但与受教育程度较低的兄弟姐妹相比，受教育程度较高的兄弟姐妹在以后生活中处于不利地位的风险较低。支持最弱势公民的教育潜力可能会减轻多重不利因素的多代传递，并减少健康和社会差距。代内和代际比较与教育破坏这种传播的可能性是一致的。在家庭中，尽管有共同的家庭背景，但与受教育程度较低的兄弟姐妹相比，受教育程度较高的兄弟姐妹在以后生活中处于不利地位的风险较低。支持最弱势公民的教育潜力可能会减轻多重不利因素的多代传递，并减少健康和社会差距。代内和代际比较与教育破坏这种传播的可能性是一致的。在家庭中，尽管有共同的家庭背景，但与受教育程度较低的兄弟姐妹相比，受教育程度较高的兄弟姐妹在以后生活中处于不利地位的风险较低。支持最弱势公民的教育潜力可能会减轻多重不利因素的多代传递，并减少健康和社会差距。