Goldberg M, Melchior M, Leclerc A, Lert F
INSERM Unité 88-IFR 69, Hôpital National de Saint-Maurice, 14, rue du Val-d'Osne, 94415 Saint-Maurice Cedex.
Rev Epidemiol Sante Publique. 2003 Sep;51(4):381-401.
The general approach of social epidemiology is based on the observation of a strong social stratification of health outcomes within populations: a similar stratification of factors associated with health must therefore also exist according to social status. To explain social differences in health, the natural approach for epidemiologists is to consider an imbalanced distribution of established risk factors according to the social position of individuals. As this approach has largely failed, two main other research areas were recently explored: (i) identification of "new" social risk factors; (ii) research of possible mechanisms of social differences in health.
Identification of social risk factors: early events and life course, occupational factors, social relationships (social networks and support, discrimination, neighborhood characteristics), health care. Research of possible mechanisms of social differences in health in the context of specific theoretical frameworks: the materialist model, the psychosocial model and the eco-social model integrating the interaction between individuals'characteristics and their environment.
definition and measurement of variables characterizing the social situation of individuals; quantification of social inequalities at population level. Observational methods must often rely on very long-lasting cohorts, and imply statistical methods that account for longitudinal data or are able to manage simultaneously individual and contextual data.
社会流行病学的一般方法基于对人群健康结果存在强烈社会分层的观察：因此，根据社会地位，与健康相关的因素也必然存在类似的分层。为了解释健康方面的社会差异，流行病学家的自然方法是考虑既定风险因素根据个体社会地位的不均衡分布。由于这种方法在很大程度上失败了，最近探索了两个主要的其他研究领域：（i）识别“新的”社会风险因素；（ii）研究健康方面社会差异的可能机制。
社会风险因素的识别：早期事件与生命历程、职业因素、社会关系（社会网络与支持、歧视、邻里特征）、医疗保健。在特定理论框架背景下研究健康方面社会差异的可能机制：唯物主义模型、心理社会模型以及整合个体特征与其环境之间相互作用的生态社会模型。
表征个体社会状况的变量的定义与测量；人群层面社会不平等的量化。观察性方法通常必须依赖非常长期的队列研究，并意味着采用考虑纵向数据或能够同时处理个体和背景数据的统计方法。
