Kaplan George A, Shema Sarah J, Leite Cláudia Maria A
Center for Social Epidemiology and Population Health, The University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
Ann Epidemiol. 2008 Jul;18(7):531-7. doi: 10.1016/j.annepidem.2008.03.006. Epub 2008 May 27.
Considerable evidence indicates that income and other measures of socioeconomic position are associated with a wide variety of health outcomes. The authors of a few studies have prospectively examined the association between socioeconomic position over the course of decades and health outcomes. The present study, covering almost three decades of the life course, examined the cumulative impact of different income measures on psychological well-being among adults.
We used data collected over the course of 29 years (1965-1994) from Alameda County Study participants to study the association between average income, income changes, profit and benefit incomes-and five scales of psychological well-being--Purpose in Life, Self-acceptance, Personal Growth, Environmental Mastery, and Autonomy. In age-adjusted models, the psychological well-being measures were each regressed on each of the income measures. Potential confounders (sex, education, race/ethnicity, social isolation, depression, and perceived health) were also examined.
Mean income over the course of almost three decades was strongly associated with all five scales of psychological well-being. Psychological well-being increased with the number of waves in which profit income was reported and with income increases over time. For all scales except Autonomy, psychological well-being decreased with the number of waves receiving need-based benefit and with decreasing income over time.
Psychological well-being may reflect the accumulation of socioeconomic advantage and disadvantage over decades.
大量证据表明,收入及社会经济地位的其他衡量指标与多种健康结果相关。一些研究的作者曾前瞻性地考察了数十年间社会经济地位与健康结果之间的关联。本研究涵盖了近三十年的人生历程,探讨了不同收入衡量指标对成年人心理健康的累积影响。
我们使用了从阿拉米达县研究参与者在29年(1965年至1994年)间收集的数据,来研究平均收入、收入变化、利润及福利收入与五个心理健康量表——生活目的、自我接纳、个人成长、环境掌控和自主性之间的关联。在年龄调整模型中,分别将每个心理健康指标对每个收入指标进行回归分析。还考察了潜在的混杂因素(性别、教育程度、种族/族裔、社会隔离、抑郁和自我感知健康状况)。
近三十年的平均收入与所有五个心理健康量表都密切相关。心理健康随着报告有利润收入的波次数量增加以及随着时间推移收入增加而提升。对于除自主性之外的所有量表,心理健康随着接受基于需求的福利的波次数量增加以及随着时间推移收入减少而下降。
心理健康可能反映了数十年间社会经济优势和劣势的积累。