Poortinga Wouter, Dunstan Frank D, Fone David L
Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, Wales, CF10 3NB, UK.
Prev Med. 2008 Apr;46(4):374-80. doi: 10.1016/j.ypmed.2007.11.015. Epub 2007 Dec 4.
Social inequalities in health are well documented in the social epidemiology literature. However, less is known about the mechanisms linking individual and area-level socio-economic status to health. In this paper we examine whether health locus of control (HLC) beliefs can help to explain socio-economic differences in self-rated health using the multidimensional HLC scale.
Data for this study come from the Caerphilly Health and Social Needs Survey (n=10,892). Multilevel modelling was used to examine the variation in HLC beliefs across different socio-demographic groups and levels of neighbourhood socio-economic status, and to investigate whether HLC beliefs mediate the health effects of individual and neighbourhood socio-economic position.
This study found that the HLC scales were significantly associated with individual and neighbourhood socio-economic status, as well as with self-rated health. HLC beliefs appeared to mediate some of the health effects of individual socio-economic status and to a lesser extent the health effects of neighbourhood socio-economic status.
Some evidence was found that HLC forms part of the pathway between individual and neighbourhood socio-economic status and health. Future research should further explore the psychological consequences of living in economically deprived conditions, alongside material, social and behavioural processes, and examine how this impacts upon people's health and well-being.
社会流行病学文献中充分记录了健康方面的社会不平等现象。然而,对于将个体和地区层面的社会经济地位与健康联系起来的机制,我们了解得较少。在本文中,我们使用多维健康控制点(HLC)量表来检验健康控制点信念是否有助于解释自评健康方面的社会经济差异。
本研究的数据来自卡菲利健康与社会需求调查(n = 10892)。采用多层次模型来检验不同社会人口群体和邻里社会经济地位水平下HLC信念的差异,并调查HLC信念是否介导个体和邻里社会经济地位对健康的影响。
本研究发现,HLC量表与个体和邻里社会经济地位以及自评健康显著相关。HLC信念似乎介导了个体社会经济地位对健康的部分影响,以及在较小程度上介导了邻里社会经济地位对健康的影响。
有证据表明,HLC是个体和邻里社会经济地位与健康之间路径的一部分。未来的研究应进一步探讨生活在经济贫困环境中的心理后果,以及物质、社会和行为过程,并研究这如何影响人们的健康和幸福。