Carlson Per
University College of South Stockholm, S-14189 Huddinge, Sweden.
Soc Sci Med. 2004 Nov;59(9):1985-92. doi: 10.1016/j.socscimed.2004.03.003.
The 'European east--west health divide' has been documented both for mortality and for self-rated health. The reason for this divide, however, remains to be explained. The aim of this study is, firstly, to investigate whether in 1995-97 differences in self-rated health persisted between countries in central and eastern Europe, the former Soviet Union, and western Europe. A further aim is to try to explain these differences with reference to people's financial status and social capital. This study found substantial differences in self-rated health between countries in western Europe, in central and eastern Europe, and in the former Soviet Union (where self-rated health seems to be poorest in general). There were also substantial differences between areas in terms of economic and social capital, with western Europe doing better in all the analysed circumstances. In economic terms people in the former Soviet Union seemed to be more dissatisfied than those living in central and eastern Europe. When one looks at differences in social capital between the two post-communist areas the picture is more mixed. Economic satisfaction was demonstrated to have a strong and significant effect on people's self-rated health, with a higher satisfaction reducing the odds of 'poor' health. When this factor was controlled for the area, differences in self-rated health were reduced dramatically, for both men and women. Organisational activity (men only), trust in people, and confidence in the legal system also reduced the odds of 'less than good health', but were not as important in explaining the health differences between areas. One can conclude that economic factors as well as some aspects of social capital play a role for area differences in self-rated health. Of these it would appear that economic factors are the more important.
“欧洲东西方健康差异”在死亡率和自评健康方面都有记录。然而，这种差异的原因仍有待解释。本研究的目的，首先是调查在1995 - 1997年期间，中欧、东欧、前苏联和西欧国家之间自评健康的差异是否持续存在。另一个目的是试图参照人们的经济状况和社会资本来解释这些差异。本研究发现，西欧、中欧和东欧以及前苏联国家（总体上自评健康似乎最差）之间在自评健康方面存在显著差异。在经济和社会资本方面，不同地区之间也存在显著差异，西欧在所有分析的情况下表现更好。在经济方面，前苏联的人们似乎比中东欧的人们更不满意。当观察两个后共产主义地区的社会资本差异时，情况更为复杂。研究表明，经济满意度对人们的自评健康有强烈且显著的影响，满意度越高，“健康状况差”的几率越低。当控制了这一因素后，不同地区的自评健康差异大幅减小，无论男性还是女性都是如此。组织活动（仅针对男性）、对他人的信任以及对法律制度的信心也降低了“健康状况不佳”的几率，但在解释不同地区之间的健康差异方面并不那么重要。可以得出结论，经济因素以及社会资本的某些方面在自评健康的地区差异中发挥了作用。其中，经济因素似乎更为重要。
