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压力、生活事件与健康方面的社会经济差异:来自“美国人生活变迁研究”的结果

Stress, life events, and socioeconomic disparities in health: results from the Americans' Changing Lives Study.

作者信息

Lantz Paula M, House James S, Mero Richard P, Williams David R

机构信息

University of Michigan School of Public Health, 109 Observatory, Ann Arbor, MI 48109-2029, USA.

出版信息

J Health Soc Behav. 2005 Sep;46(3):274-88. doi: 10.1177/002214650504600305.

DOI:10.1177/002214650504600305
PMID:16259149
Abstract

It has been hypothesized that exposure to stress and negative life events is related to poor health outcomes, and that differential exposure to stress plays a role in socioeconomic disparities in health. Data from three waves of the Americans' Changing Lives study (n = 3,617) were analyzed to investigate prospectively the relationship among socioeconomic indicators, five measures of stress/negative life events, and the health outcomes of mortality, functional limitations, and self-rated health. The results revealed that (1) life events and other types of stressors are clearly related to socioeconomic position; (2) a count of negative lifetime events was positively associated with mortality; (3) a higher score on a financial stress scale was predictive of severe/moderate functional limitations and fair/poor self-rated health at wave 3; and (4) a higher score on a parental stress scale was predictive of fair/poor self-rated health at wave 3. The negative effects of low income on functional limitations attenuated to insignificance when waves 1 and 2 stress/life event measures were controlled for, but other socioeconomic disparities in health change remained sizable and significant when adjusted for exposure to stressors. The results support the hypothesis that differential exposure to stress and negative life events is one of many ways in which socioeconomic inequalities in health are produced in society.

摘要

有假设认为,暴露于压力和负面生活事件与健康状况不佳有关,且压力暴露的差异在健康方面的社会经济差距中起作用。对来自“美国人生活变化”研究三轮调查的数据(n = 3617)进行了分析,以前瞻性地研究社会经济指标、压力/负面生活事件的五项测量指标与死亡率、功能受限和自评健康等健康结果之间的关系。结果显示:(1)生活事件和其他类型的压力源与社会经济地位明显相关;(2)一生负面事件的计数与死亡率呈正相关;(3)在财务压力量表上得分较高可预测第三轮调查时严重/中度功能受限以及自评健康状况为一般/较差;(4)在父母压力量表上得分较高可预测第三轮调查时自评健康状况为一般/较差。当控制第一轮和第二轮调查的压力/生活事件测量指标时,低收入对功能受限的负面影响减弱至不显著,但在调整压力源暴露后,健康方面的其他社会经济差距仍然很大且显著。结果支持了以下假设:压力和负面生活事件的差异暴露是社会中产生健康方面社会经济不平等的众多方式之一。

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