Morris J N, Donkin A J, Wonderling D, Wilkinson P, Dowler E A
Health Promotion Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
J Epidemiol Community Health. 2000 Dec;54(12):885-9. doi: 10.1136/jech.54.12.885.
Half a century of research has provided consensual evidence of major personal requisites of adult health in nutrition, physical activity and psychosocial relations. Their minimal money costs, together with those of a home and other basic necessities, indicate disposable income that is now essential for health.
In a first application we identified such representative minimal costs for healthy, single, working men aged 18-30, in the UK. Costs were derived from ad hoc survey, relevant figures in the national Family Expenditure Survey, and by pragmatic decision for the few minor items where survey data were not available.
Minimum costs were assessed at 131.86 pound sterling per week (UK April 1999 prices). Component costs, especially those of housing (which represents around 40% of this total), depend on region and on several assumptions. By varying these a range of totals from 106.47 pound sterling to 163.86 pound sterling per week was detailed. These figures compare, 1999, with the new UK national minimum wage, after statutory deductions, of pound 105.84 at 18-21 years and 121.12 pound sterling at 22+ years for a 38 hour working week. Corresponding basic social security rates are 40.70 pound sterling to 51.40 pound sterling per week.
Accumulating science means that absolute standards of living, "poverty", minimal official incomes and the like, can now be assessed by objective measurement of the personal capacity to meet the costs of major requisites of healthy living. A realistic assessment of these costs is presented as an impetus to public discussion. It is a historical role of public health as social medicine to lead in public advocacy of such a national agenda.
半个世纪的研究已就成人健康在营养、身体活动和社会心理关系方面的主要个人需求提供了一致的证据。它们与住房及其他基本生活必需品的最低资金成本表明,可支配收入如今对健康至关重要。
在首次应用中,我们确定了英国18至30岁健康单身在职男性的此类代表性最低成本。成本源自专项调查、国家家庭支出调查中的相关数据,以及针对少数无调查数据的小项目所做的务实决策。
最低成本评估为每周131.86英镑(1999年4月英国物价)。构成成本,尤其是住房成本(约占总成本的40%),取决于地区及若干假设。通过改变这些因素,详细列出了每周从106.47英镑到163.86英镑的一系列总成本。这些数字与1999年英国新的国家最低工资相比,18至21岁法定扣除后的为105.84英镑,22岁及以上每周工作38小时的为121.12英镑。相应基本社会保障费率为每周40.70英镑至51.40英镑。
不断积累的科学知识意味着,现在可以通过客观衡量个人满足健康生活主要需求成本的能力,来评估绝对生活标准、“贫困”、官方最低收入等情况。对这些成本的现实评估是推动公众讨论的动力。作为社会医学的公共卫生在倡导这样一项国家议程方面发挥引领作用,这是其历史使命。