Regidor Enrique
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Complutense de Madrid, Ciudad Universitaria, 28040 Madrid, Spain.
J Epidemiol Community Health. 2006 Oct;60(10):896-901. doi: 10.1136/jech.2005.044859.
The emergence of theoretical models of social determinants of health has added conceptual ambiguity to the understanding of social inequalities in health, as it is often not possible to clearly distinguish between socioeconomic position and these determinants. Whether the existence of social inequalities in health is based on differences in health or on differences in social determinants of health that are systematically associated with socioeconomic position, policymakers should be clearly informed of the importance of socioeconomic position for health. Thus, the following three basic requirements are proposed: to reach a consensus about the dimensions that reflect socioeconomic position; to agree about what are to be considered the social determinants of health and whether or not these determinants are a construct that can be distinguished from socioeconomic position; and finally, to establish which dimensions and measures of socioeconomic position are most appropriate for the evaluation of interventions that aim to reduce these inequalities.
健康社会决定因素理论模型的出现，给理解健康方面的社会不平等增添了概念上的模糊性，因为往往无法清楚地区分社会经济地位与这些决定因素。无论健康方面社会不平等的存在是基于健康差异，还是基于与社会经济地位系统相关的健康社会决定因素差异，政策制定者都应清楚地了解社会经济地位对健康的重要性。因此，提出以下三项基本要求：就反映社会经济地位的维度达成共识；就哪些应被视为健康的社会决定因素以及这些决定因素是否是可与社会经济地位区分开来的一种结构达成一致；最后确定社会经济地位的哪些维度和衡量标准最适合评估旨在减少这些不平等现象的干预措施。
