Monden Christiaan
Department of Sociology, Tilburg University, The Netherlands.
Scand J Public Health. 2004;32(3):217-23. doi: 10.1080/14034940310019470.
Socioeconomic health differences have been studied elaborately for many Western societies. Relatively little is know about the social variations in health in the former communist states of Eastern Europe. This study investigated socioeconomic health inequalities in Latvia.
Cross-sectional analysis was undertaken of the 1999 Norbalt-II Living Conditions Survey, a random population-based sample in Latvia, and included males and females aged 25 to 70.
Lower educated subjects had higher rates of self-assessed poor health than those with tertiary education (men OR 2.21; 1.31-3.71 95% CI, and women OR 2.48; 1.74-3.54 95% CI). After adjusting for income, educational differences were significant only for women. Income differences were larger than educational differences in self-assessed poor health for both genders (OR of highest vs. lowest quintile for men: 5.10; 2.26-11.5 95% CI, women: OR 3.26; 1.92-5.51 95% CI). For long-standing health problems socioeconomic differences were smaller. After adjusting for income no educational differences were found, but income differences were significant (men: OR 2.06; 1.15-3.69 95% CI, women: OR 1.42; 1.12-2.63 95% CI). The economically non-active were in worse health than the (self-)employed subjects (men: OR 6.12; 3.65-10.3 95% CI, women: OR 2.79; 1.66-3.39 95% CI).
Substantial social inequalities in self-assessed poor health and longstanding health problems exist in Latvia for both sexes. Inequalities by material circumstances, as measured by income, appear to be larger than educational differences. Economic activity was also strongly associated with health. There were no inequalities with regard to urbanization and ethnic differences were found only for long-standing health problems among women.
许多西方社会对社会经济健康差异进行了详尽研究。对于东欧前共产主义国家健康状况的社会差异,人们了解相对较少。本研究调查了拉脱维亚的社会经济健康不平等情况。
对1999年诺尔巴特-II生活状况调查进行横断面分析,该调查是拉脱维亚基于随机抽样的人口样本,涵盖年龄在25至70岁的男性和女性。
受教育程度较低的人群自我评估的健康状况较差的比例高于受过高等教育的人群(男性优势比为2.21;95%置信区间为1.31 - 3.71,女性优势比为2.48;95%置信区间为1.74 - 3.54)。在对收入进行调整后,教育差异仅在女性中显著。在自我评估的健康状况较差方面,收入差异大于教育差异(男性最高五分位数与最低五分位数的优势比:5.10;95%置信区间为2.26 - 11.5,女性:优势比3.26;95%置信区间为1.92 - 5.51)。对于长期健康问题,社会经济差异较小。在对收入进行调整后,未发现教育差异,但收入差异显著(男性:优势比2.06;95%置信区间为1.15 - 3.69,女性:优势比1.42;95%置信区间为1.12 - 2.63)。经济不活跃人群的健康状况比(自主)就业人群更差(男性:优势比6.12;95%置信区间为3.65 - 10.3,女性:优势比2.79;95%置信区间为1.66 - 3.39)。
拉脱维亚男女在自我评估的健康状况较差和长期健康问题方面存在显著的社会不平等。以收入衡量的物质条件方面的不平等似乎大于教育差异。经济活动也与健康密切相关。在城市化方面不存在不平等,且仅在女性的长期健康问题中发现了种族差异。