Ahnquist Johanna, Fredlund Peeter, Wamala Sarah P
Swedish National Institute of Public Health, Olof Palmes gata 17, SE-103 52 Stockholm, Sweden.
J Epidemiol Community Health. 2007 Apr;61(4):331-6. doi: 10.1136/jech.2006.049395.
Previous research has shown an association between cumulative economic hardships and various health outcomes. However, the cumulative effects of economic hardships in regard to gender differences have not been given enough attention.
1981 women and 1799 men were followed up over a period of 16 years (1981-1997), using data from the Swedish Survey of Living Conditions panel study. The temporal association between economic hardships and self-rated health, psychological distress and musculoskeletal disorders was analysed.
A dose-response effect on women's health was observed with increasing scores of cumulative exposure to financial stress but not with low income. Women exposed to financial stress at both T(1) and T(2) had an increased risk of 1.4-1.6 for all health measures compared with those who were not exposed. A similar consistent dose-response effect was not observed among men.
There is a temporal relationship between cumulative economic hardships and health outcomes, and health effects differ by gender. Financial stress seems to be a stronger predictor of poor health outcomes than low income, particularly among women. Policies geared towards reducing health inequalities should recognise that long-term exposure to economic hardships damages health, and actions need to be taken with a gender perspective.
先前的研究表明,累积经济困难与各种健康结果之间存在关联。然而,经济困难在性别差异方面的累积影响尚未得到足够重视。
利用瑞典生活条件调查面板研究的数据,对1981名女性和1799名男性进行了为期16年(1981 - 1997年)的随访。分析了经济困难与自评健康、心理困扰和肌肉骨骼疾病之间的时间关联。
随着累积暴露于经济压力得分的增加,观察到对女性健康有剂量反应效应,但低收入情况并非如此。与未暴露的女性相比,在T(1)和T(2)时均暴露于经济压力的女性在所有健康指标上的风险增加了1.4 - 1.6倍。在男性中未观察到类似一致的剂量反应效应。
累积经济困难与健康结果之间存在时间关系,且健康影响因性别而异。经济压力似乎比低收入更能预测不良健康结果,尤其是在女性中。旨在减少健康不平等的政策应认识到长期暴露于经济困难会损害健康,并且需要从性别角度采取行动。