Chandola T, Bartley M, Wiggins R, Schofield P
Department of Epidemiology and Public Health, University College London, London, UK.
J Epidemiol Community Health. 2003 Jan;57(1):56-62. doi: 10.1136/jech.57.1.56.
It is increasingly recognised that different dimensions of social inequality may be linked to health by different pathways. Furthermore, factors operating at the individual level such as employment conditions may affect health in a different way from household level factors. The paper examines the associations between self rated health and four measures of social position- occupational class, household social advantage, personal and household income.
Multilevel logistic regression models were used to predict self rated health using longitudinal data from the British Household panel survey (BHPS) with respondents nested within households. Separate analyses were carried out for economically active and inactive respondents.
Interview based surveys of adults living within households that are representative of British households.
Adult respondents from the BHPS.
Occupational class has relatively strong effects on the self rated health of the economically active, although household level factors also seem to influence their health. Household social advantage has relatively strong effects on the self rated health of the economically inactive.
The paper found evidence in support of the view that different dimensions of social inequality have different pathways to self rated health. There are unexplained similarities in health between household members, which require further investigation.
人们越来越认识到,社会不平等的不同维度可能通过不同途径与健康相关联。此外,诸如就业条件等个体层面的因素可能与家庭层面的因素以不同方式影响健康。本文考察自评健康状况与社会地位的四项指标——职业阶层、家庭社会优势、个人和家庭收入之间的关联。
采用多水平逻辑回归模型,利用英国家庭调查(BHPS)的纵向数据预测自评健康状况,受访者嵌套于家庭之中。对经济活跃和不活跃的受访者分别进行分析。
对居住在具有英国家庭代表性的家庭中的成年人进行基于访谈的调查。
BHPS的成年受访者。
职业阶层对经济活跃者的自评健康有相对较强的影响,尽管家庭层面的因素似乎也会影响他们的健康。家庭社会优势对经济不活跃者的自评健康有相对较强的影响。
本文发现证据支持这样一种观点,即社会不平等的不同维度通往自评健康的途径不同。家庭成员之间在健康方面存在无法解释的相似之处,这需要进一步调查。