Lahelma Eero, Martikainen Pekka, Rahkonen Ossi, Roos Eva, Saastamoinen Peppiina
Department of Public Health, University of Helsinki, Finland.
Eur J Public Health. 2005 Oct;15(5):504-10. doi: 10.1093/eurpub/cki022. Epub 2005 Jul 13.
Studies comparing socioeconomic inequalities in health using several health indicators are scarce. Therefore, this study aims to compare the shape and magnitude of occupational class inequalities across key domains of health, i.e. the subjective, functional and medical domains. Additionally, we examine whether physical or mental workload will affect these inequalities, and whether these effects are specific to particular health indicators.
Cross-sectional survey data from the Helsinki Health Study in 2000 and 2001 were used. Each year employees of the City of Helsinki, reaching 40, 45, 50, 55 and 60 years received a mailed questionnaire. 6243 employees responded (80% women, response rate 68%). The socioeconomic indicator was occupational social class. Nine health indicators were included: self-rated health, pain or ache, GHQ-12 mental well-being, limiting long-standing illness, SF-36 physical and mental health functioning, Rose angina symptoms, circulatory diseases and mental problems. Prevalence percentages, odds ratios and inequality indices from logistic regression analysis were calculated.
Occupational class inequalities were found for self-rated health, pain or ache, limiting long-standing illness, physical health functioning, angina symptoms, and circulatory diseases. Physical or mental workload did not account for these inequalities. Inequalities were non-existent or slightly reversed for GHQ-12 mental well-being, SF-36 mental health functioning and mental problems.
Expected occupational class inequalities in health among both women and men were found for global and physical health but not for mental health. The observed inequalities could not be attributed to physical or mental workload.
使用多种健康指标比较健康方面社会经济不平等的研究较少。因此，本研究旨在比较职业阶层在健康关键领域（即主观、功能和医学领域）不平等的形式和程度。此外，我们研究身体或精神工作量是否会影响这些不平等，以及这些影响是否特定于特定的健康指标。
使用了2000年和2001年赫尔辛基健康研究的横断面调查数据。每年，赫尔辛基市40、45、50、55和60岁的员工都会收到一份邮寄问卷。6243名员工做出了回应（80%为女性，回复率68%）。社会经济指标是职业社会阶层。纳入了九个健康指标：自评健康、疼痛、GHQ-12心理健康、长期慢性病、SF-36身体和心理健康功能、玫瑰型心绞痛症状、循环系统疾病和心理问题。计算了逻辑回归分析的患病率百分比、优势比和不平等指数。
在自评健康、疼痛、长期慢性病、身体健康功能、心绞痛症状和循环系统疾病方面发现了职业阶层不平等。身体或精神工作量不能解释这些不平等。在GHQ-12心理健康、SF-36心理健康功能和心理问题方面不存在不平等或不平等略有反转。
在全球和身体健康方面发现了男性和女性中预期的职业阶层健康不平等，但在心理健康方面未发现。观察到的不平等不能归因于身体或精神工作量。
