van Lenthe Frank J, Schrijvers Carola T M, Droomers Mariel, Joung Inez M A, Louwman Marieke J, Mackenbach Johan P
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Eur J Public Health. 2004 Mar;14(1):63-70. doi: 10.1093/eurpub/14.1.63.
The GLOBE study is a prospective cohort study specifically aimed at the explanation of socio-economic inequalities in health in the Netherlands. The returns of the study are reviewed after ten years of follow-up, and the studies' contribution to the development of policy measures to reduce inequalities in health in the Netherlands are described.
The study started in 1991 with a baseline postal survey (response rate 70.1% or n=18973, 15-74 years of age). Two sub-samples of respondents to this survey were subsequently interviewed in 1991 (response 79.4% and 72.3%, n=5667). Baseline data collection included measures of socio-economic position, health and possible explanatory factors. Follow-up involved repeated postal surveys and interviews, and routinely collected data on hospital admissions, cancer incidence and mortality by cause of death.
Compared with higher socio-economic groups, lower socio-economic groups showed higher prevalence rates of poor self-reported health (perceived general health, health complaints, chronic conditions, disabilities), higher incidence rates of specific conditions (myocardial infarction) and higher rates of all-cause mortality. The higher prevalence of adverse material circumstances, unhealthy behaviour, adverse psychosocial characteristics, and adverse childhood circumstances in the lower socio-economic groups was important in the explanation of socio-economic inequalities in health. Socio-economic differences in health care utilization did not contribute to the explanation.
The GLOBE study contributed significantly to the understanding of the explanation of socio-economic inequalities in health in the Netherlands. Study results were a main source of information in the development of policy measures aimed at the reduction of socio-economic inequalities in health in the Netherlands.
GLOBE研究是一项前瞻性队列研究，专门旨在解释荷兰健康方面的社会经济不平等现象。在随访十年后对该研究的成果进行了回顾，并描述了该研究对荷兰制定减少健康不平等政策措施的贡献。
该研究始于1991年，采用基线邮政调查（应答率70.1%或n = 18973，年龄在15 - 74岁之间）。随后在1991年对该调查的两个受访者子样本进行了访谈（应答率分别为79.4%和72.3%，n = 5667）。基线数据收集包括社会经济地位、健康状况及可能的解释因素的测量。随访包括重复的邮政调查和访谈，并常规收集有关住院、癌症发病率和死因死亡率的数据。
与社会经济地位较高的群体相比，社会经济地位较低的群体自我报告的健康状况较差（感知的总体健康、健康问题、慢性病、残疾）的患病率更高，特定疾病（心肌梗死）的发病率更高，全因死亡率也更高。社会经济地位较低的群体中不利物质环境、不健康行为、不良心理社会特征和不良童年环境的较高患病率，对于解释健康方面的社会经济不平等现象很重要。医疗保健利用方面的社会经济差异对这种解释没有作用。
GLOBE研究对理解荷兰健康方面的社会经济不平等现象的解释做出了重大贡献。研究结果是荷兰制定旨在减少健康方面社会经济不平等政策措施的主要信息来源。
