Jankowska Ewa Anita, Szklarska Alicja, Lipowicz Anna, Lopuszańska Monika, Koziel Sławomir, Bielicki Tadeusz
Cardiology Department, Military Hospital, Wrocław, Poland.
J Biosoc Sci. 2008 May;40(3):401-12. doi: 10.1017/S0021932007002635. Epub 2007 Dec 20.
In modern societies, there are regular social gradients in most health parameters, and also in the structure of morbidity and mortality. However, the significance of inter-generation social mobility for general health status still remains equivocal. This study was therefore performed in order to compare the effect of social mobility on coronary heart disease (CHD) risk between middle-aged Polish men and women. A total of 342 men and 458 women, aged 40 and 50 and inhabitants of Wrocław, were examined. Risk of CHD was estimated using the Framingham Risk Score (FRS), calculated for each individual. Social mobility was defined as an inter-generation change in social status expressed as educational level between the examined individual and his/her father. Using two-variable regression models, it was demonstrated that FRS in men was determined by both their father's education level (beta=0.33, p<0.0001) and inter-generation change in educational status (beta=0.18, p=0.008). In contrast, FRS in women was related only to their father's education level (beta=0.35, p<0.0001), but not to inter-generation social mobility (beta=0.35, p=0.25). In particular, an incremental change in educational level among those men whose father had finished primary school at the very most or among those whose father had finished basic trade school was accompanied by a significant decrease in FRS (F=4.12, p=0.009 and F=3.25, p=0.04, respectively). It is concluded that inter-generation social mobility modifies CHD risk (as estimated using FRS) in middle-aged Polish men, but not in women. The precise mechanisms responsible for the observed sex difference in this phenomenon need to be established in further studies.
在现代社会中,大多数健康指标以及发病率和死亡率结构都存在常规的社会梯度差异。然而,代际社会流动对总体健康状况的影响仍不明确。因此,本研究旨在比较社会流动对波兰中年男性和女性冠心病(CHD)风险的影响。共对弗罗茨瓦夫的342名男性和458名年龄在40至50岁之间的女性居民进行了检查。使用弗雷明汉风险评分(FRS)对每位个体的冠心病风险进行评估。社会流动被定义为受调查个体与其父亲之间以教育水平表示的代际社会地位变化。通过双变量回归模型表明,男性的FRS既由其父亲的教育水平决定(β = 0.33,p < 0.0001),也受教育地位的代际变化影响(β = 0.18,p = 0.008)。相比之下,女性的FRS仅与其父亲的教育水平相关(β = 0.35,p < 0.0001),而与代际社会流动无关(β = 0.35,p = 0.25)。特别是,对于那些父亲最多只完成小学教育的男性或父亲完成基础职业学校教育的男性,教育水平的逐步提高伴随着FRS的显著降低(F = 4.12,p = 0.009和F = 3.25,p = 0.04)。研究得出结论,代际社会流动会改变波兰中年男性的冠心病风险(如用FRS评估),但对女性没有这种影响。这种现象中观察到的性别差异的确切机制需要在进一步研究中确定。