Kopp Mária S, Skrabski Arpád, Székely András, Stauder Adrienne, Williams Redford
Institute of Behavioral Sciences, Semmelweis University, Budapest, H-1089, Hungary.
Ann N Y Acad Sci. 2007 Oct;1113:325-38. doi: 10.1196/annals.1391.006. Epub 2007 May 4.
In the last decades in the transforming societies of Central and Eastern Europe, premature mortality increased dramatically, especially among men. Increasing disparities in socioeconomic conditions have been accompanied by a widening socioeconomic gradient in mortality among men. Social cohesion and meaning in life may help to counterbalance the widening gap in material circumstances. Not the difficult social situation in itself, but the subjective experience of relative disadvantage, the prolonged negative emotional state, that is, chronic stress seems to be the most important risk factor. The health consequences of a low socioeconomic situation among men might be mostly explained by chronic stress caused by work and close-partner-related factors, and the toxic components of this interaction are depression and hopelessness. In the case of women, the broader personal and family relations are the most important health-related factors. Weekend workload, low social support at work and low control at work accounted for a large part of variation in male premature cardiovascular mortality rates, whereas job insecurity, high weekend workload, and low control at work contribute most markedly to variations in premature cardiovascular mortality rates among women. There are two general approaches that scientists and practitioners might take: train individuals and groups to use skills that will enable them to cope better with the stressful conditions that are damaging their health; and lobby governments to adopt policies that will result in decreased chronic stress on the societal level.
在过去几十年中，中东欧处于转型期的社会中，过早死亡率急剧上升，尤其是在男性中。社会经济状况差距不断扩大的同时，男性死亡率的社会经济梯度也在加大。社会凝聚力和生活意义可能有助于平衡物质条件方面日益扩大的差距。并非艰难的社会状况本身，而是相对劣势的主观体验、长期的负面情绪状态，即慢性压力，似乎才是最重要的风险因素。男性社会经济地位低下对健康的影响，可能主要由工作及与亲密伴侣相关因素导致的慢性压力来解释，这种相互作用的有害因素是抑郁和绝望。就女性而言，更广泛的个人和家庭关系是最重要的与健康相关的因素。周末工作量、工作中的社会支持不足以及工作控制权低，在男性过早心血管死亡率的变化中占很大比例，而工作不稳定、周末工作量大以及工作控制权低，对女性过早心血管死亡率变化的影响最为显著。科学家和从业者可能采取两种一般方法：培训个人和群体运用技能，使其能更好地应对损害自身健康的压力状况；游说政府采取政策，以减少社会层面的慢性压力。
