Byth K, McIntosh J H, Piper D W
Department of Medicine, University of Sydney, Royal North Shore Hospital, St Leonards, NSW.
Aust J Public Health. 1992 Sep;16(3):321-3. doi: 10.1111/j.1753-6405.1992.tb00073.x.
Simple indicators such as education, income, occupation, and employment status are often used to adjust for social class in studies of morbidity or mortality. The effect of social class on such outcomes can be different for men and women. In population-based studies, residential area may be the only means of assessing social class. This study investigated sex differences in the association between mortality between 1979 and 1983 and several area indices of social class--percentage with a degree, percentage professional, percentage blue collar, percentage unemployed, percentage with annual income greater than $40,000, and the composite indicator constructed by the Australian Bureau of Statistics. Thirty-seven Sydney statistical local areas were ranked for men and women separately according to the indicators and standardised mortality ratios. Correlations between the indicators and mortality were all negative and stronger for men than for women. The composite indicator and percentage unemployed correlated most strongly with mortality. There was a moderate correlation between the remaining indicators and mortality for men, but only a weak correlation for women. The results suggest that the use of simple area indicators may be inadequate to classify the social class of women, and that the unemployment rate in those over 35 years of age may be a reasonable alternative to the composite indicator for the purpose of social class adjustment in mortality studies.
诸如教育程度、收入、职业和就业状况等简单指标，在发病率或死亡率研究中常被用来调整社会阶层因素。社会阶层对这些结果的影响在男性和女性中可能有所不同。在基于人群的研究中，居住区域可能是评估社会阶层的唯一方式。本研究调查了1979年至1983年间死亡率与社会阶层的几个区域指标之间关联的性别差异，这些指标包括拥有学位的百分比、专业人员百分比、蓝领百分比、失业百分比、年收入超过40000美元的百分比以及澳大利亚统计局构建的综合指标。根据这些指标和标准化死亡率，分别对悉尼的37个统计局部区域的男性和女性进行了排名。指标与死亡率之间的相关性均为负，且男性的相关性强于女性。综合指标和失业百分比与死亡率的相关性最强。其余指标与男性死亡率之间存在中等程度的相关性，但与女性死亡率的相关性较弱。结果表明，使用简单的区域指标可能不足以对女性的社会阶层进行分类，对于死亡率研究中的社会阶层调整而言，35岁以上人群的失业率可能是综合指标的一个合理替代指标。
