Cubbins L A, Szaflarski M
Centers for Public Health Research and Evaluation, Battelle Seattle Research Center, WA 98105-3949, USA.
Soc Sci Med. 2001 Dec;53(12):1653-66. doi: 10.1016/s0277-9536(00)00450-0.
Alcohol abuse and a transition to the market economy are often blamed for high mortality and low life expectancy in Russia, but little is known about proximate influences on individual health. This study estimates family influences on the self-reported health of Russian wives and husbands. Predicting gender differences in the determinants of health status, hypotheses are presented for the effects on spouses' self-reported health of five family characteristics: economic status, household division of labor, family decision-making, presence of young children, and housing conditions. Controls are included for age, education, sensitivity, alcohol use, job-related time, and urban-rural location. Data from a 1996 sample of couples (n = 925) from Moscow and two rural regions of Russia are analyzed using logistic regression. The findings provide mixed support for the hypotheses, though they do show the important role of family characteristics on spouses' health. Family economic standing is important to both spouses' self-reported health, though young children in the home is not. Family decision-making does influence spouses' health: when Russian wives are the primary decision makers in the family, their own health suffers, though their husbands' health is better. And support is found for the combined effects of job-related time and household labor but only for wives' health. When wife's household labor is low, the probability of her having poor health increases, the more time she devotes to her job. However, when she does substantially more domestic labor than her husband, her job-related time has the opposite effect, reducing the chances of poor health, the more time she spends on job activities. This study is important both in helping to account for poor health of Russians during the current economic and social transition and in identifying aspects of family life that affect men's and women's health cross-nationally.
酗酒和向市场经济的转型常被认为是俄罗斯高死亡率和低预期寿命的罪魁祸首，但对于影响个人健康的直接因素却知之甚少。本研究估计了家庭对俄罗斯夫妻自我报告健康状况的影响。在预测健康状况决定因素中的性别差异时，提出了关于五个家庭特征对配偶自我报告健康状况影响的假设：经济状况、家务分工、家庭决策、幼儿的存在以及住房条件。控制变量包括年龄、教育程度、敏感度、饮酒情况、与工作相关的时间以及城乡居住地。使用逻辑回归分析了1996年从莫斯科和俄罗斯两个农村地区抽取的夫妻样本（n = 925）的数据。研究结果对这些假设提供了混合支持，不过确实显示了家庭特征对配偶健康的重要作用。家庭经济状况对夫妻双方自我报告的健康都很重要，不过家中有幼儿这一因素并非如此。家庭决策确实会影响配偶的健康：当俄罗斯妻子是家庭中的主要决策者时，她们自己的健康会受到影响，不过其丈夫的健康状况会更好。并且发现了与工作相关的时间和家务劳动的综合影响，但仅针对妻子的健康。当妻子的家务劳动较少时，她健康状况不佳的概率会增加，她投入工作的时间越多，这种情况越明显。然而，当她承担的家务劳动比丈夫多得多时，她与工作相关的时间会产生相反的效果，她花在工作活动上的时间越多，健康状况不佳的可能性就越小。这项研究不仅有助于解释当前经济和社会转型期间俄罗斯人健康状况不佳的原因，还有助于识别在跨国层面上影响男性和女性健康的家庭生活方面。
