Doolan Katherine, Ehrlich Rodney, Myer Landon
School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
PLoS One. 2007 Dec 12;2(12):e1290. doi: 10.1371/journal.pone.0001290.
Violence is a leading cause of morbidity and mortality in South Africa and needs to be researched from a public health perspective. Typically in violence research, socioeconomic position is used in the analysis to control for confounding. Social epidemiology approaches this variable as a primary determinant of interest and is used in this research to better understand the aetiology of violence in South Africa. We hypothesised that measures of socioeconomic position (employment, education and household wealth) would be inversely related to violence at the individual and household levels.
METHODOLOGY/PRINCIPAL FINDINGS: Data came from the 1998 South African Demographic and Health Survey (SADHS). Measures of socioeconomic position used were employment, education and household wealth. Eighty-eight people (0.2%) received treatment for a violent injury in the previous 30 days and 103 households (0.9%) experienced a violent death in the previous year. Risk factors for violence at the individual level included employment (41% of those who experienced violence were employed vs. 27% of those who did not, p = 0.02), and education (those who experienced violence had on average, one year more education than those who did not, p = 0.04). Belonging to a household in the wealthiest quintile was protective against violence (OR: 0.32; 95% CI: 0.12-0.89). In contrast, at the household level all three measures of socioeconomic position were protective against the experience of a violent death. The only association to persist in the multivariate analysis was that between the wealth of the household and violence at the individual level.
CONCLUSIONS/SIGNIFICANCE: Our hypothesis was supported if household wealth was used as the measure of socioeconomic position at the individual level. While more research is needed to inform the conflicting results observed between the individual and household levels, this analysis has begun to identify the disparities across the socioeconomic structure with respect to violent outcomes.
暴力是南非发病和死亡的主要原因，需要从公共卫生角度进行研究。在暴力研究中，通常在分析时使用社会经济地位来控制混杂因素。社会流行病学将这一变量视为主要的研究决定因素，本研究中用其来更好地理解南非暴力的病因。我们假设社会经济地位指标（就业、教育和家庭财富）在个人和家庭层面与暴力呈负相关。
方法/主要发现：数据来自1998年南非人口与健康调查（SADHS）。所使用的社会经济地位指标为就业、教育和家庭财富。在过去30天内，88人（0.2%）因暴力伤害接受治疗，103户家庭（0.9%）在上一年经历了暴力死亡。个人层面暴力的风险因素包括就业（经历暴力的人中有41%就业，未经历暴力的人中有27%就业，p = 0.02）和教育（经历暴力的人平均比未经历暴力的人多接受一年教育，p = 0.04）。属于最富有五分之一家庭可预防暴力（比值比：0.32；95%置信区间：0.12 - 0.89）。相比之下，在家庭层面，社会经济地位的所有三个指标都可预防暴力死亡事件。多变量分析中唯一持续存在的关联是家庭财富与个人层面暴力之间的关联。
结论/意义：如果将家庭财富用作个人层面社会经济地位的衡量指标，我们的假设得到了支持。虽然需要更多研究来解释个人和家庭层面观察到的相互矛盾的结果，但该分析已开始确定社会经济结构在暴力结果方面的差异。
