Pearlin Leonard I, Schieman Scott, Fazio Elena M, Meersman Stephen C
Department of Sociology, Art-Sociology Building, University of Maryland, College Park, MD 20742-1315, USA.
J Health Soc Behav. 2005 Jun;46(2):205-19. doi: 10.1177/002214650504600206.
This article proposes several conceptual perspectives designed to advance our understanding of the material and experiential conditions contributing to persistent disparities in rates of morbidity and mortality among groups unequal in their social and economic statuses. An underlying assumption is that these disparities, which are in clear evidence at mid- and late life, may be anchored to earlier circumstances of the life course. Of particular interest are those circumstances resulting in people with the least privileged statuses having the greatest chances of exposure to health-related stressors. Among the stressors closely linked to status and status attainment are those that continue or are repeated across the life course, such as enduring economic strain and discriminatory experiences. Also taking a long-range toll on health are circumstances of stress proliferation, a process that places people exposed to a serious adversity at risk for later exposure to additional adversities. We suggest that this process can be observed in instances of trauma, in early out-of-sequence transitions, and in the case of undesired changes that disrupt behaviors and relationships in established roles. Effective effort to close the systemic health gaps must recognize their structural underpinnings.
本文提出了几个概念性视角，旨在促进我们对那些导致社会经济地位不平等群体间发病率和死亡率持续存在差异的物质和体验条件的理解。一个基本假设是，这些在中年和晚年明显存在的差异，可能与生命历程早期的情况有关。特别令人感兴趣的是那些导致社会地位最不利的人接触与健康相关压力源机会最大的情况。与地位和地位获得密切相关的压力源包括那些在生命历程中持续或反复出现的压力源，如长期的经济压力和歧视经历。压力扩散的情况也会对健康造成长期影响，这一过程使遭受严重逆境的人面临随后接触更多逆境的风险。我们认为，在创伤事件、早期不合时宜的转变以及破坏既定角色中的行为和关系的意外变化中都可以观察到这一过程。缩小系统性健康差距的有效努力必须认识到其结构基础。
