Gorman Bridget K, Sivaganesan Ahilan
Rice University, Houston, TX, USA.
Soc Sci Med. 2007 Sep;65(5):958-75. doi: 10.1016/j.socscimed.2007.04.017. Epub 2007 May 23.
This paper examines socioeconomic (socioeconomic status, SES) disparities in self-rated health and hypertension among 29,816 US adults aged 25 and older using data from the 2001 wave of the National Health Interview Survey. Our purpose is to examine how influential measures of social support and social integration are for each health outcome, and whether support and integration operate by mediating, or buffering, the effects of SES on health. Multivariate regression models show no significant influence of emotional support, but do indicate that many aspects of social integration are directly associated with self-rated health and hypertension, although these measures do not mediate the relationship between SES and health. However, interaction tests show substantial evidence that measures of social integration buffer some of the negative effects of low SES, particularly the negative influence of not working on self-rated health. In addition, findings indicate potential evidence of help-seeking behavior among adults who did not finish high school or who report financial barriers to medical care. Overall, our findings suggest that social programs designed to foster social integration (e.g., free or low-cost bus fare to promote visits with friends and family) may improve health among persons with low levels of education, who are not working, or who have problems accessing medical care because of financial problems.
本文利用2001年全国健康访谈调查的数据,研究了29816名25岁及以上美国成年人在自评健康和高血压方面的社会经济(社会经济地位,SES)差异。我们的目的是研究社会支持和社会融合的相关指标对每种健康结果的影响程度,以及支持和融合是否通过调节或缓冲SES对健康的影响来发挥作用。多元回归模型显示,情感支持没有显著影响,但表明社会融合的许多方面与自评健康和高血压直接相关,尽管这些指标并未调节SES与健康之间的关系。然而,交互检验显示有大量证据表明,社会融合指标缓冲了低SES的一些负面影响,特别是不工作对自评健康的负面影响。此外,研究结果表明,未完成高中学业或报告存在医疗费用经济障碍的成年人存在求助行为的潜在证据。总体而言,我们的研究结果表明,旨在促进社会融合的社会项目(例如,提供免费或低成本公交票价以促进与朋友和家人的探访)可能会改善教育程度低、未就业或因经济问题而难以获得医疗服务的人群的健康状况。