Department of Health Disparities Research, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
J Behav Med. 2009 Dec;32(6):545-57. doi: 10.1007/s10865-009-9226-3. Epub 2009 Sep 16.
Although socioeconomic status is a major contributing factor to health disparities, the mechanisms through which socioeconomic status influences health remain unclear. The purpose of the present study was to evaluate an a priori conceptual model of the pathways between socioeconomic status and modifiable health risk factors in a sample of 399 African Americans seeking smoking cessation treatment. A latent variable modeling approach was utilized to characterize the interrelationships among socioeconomic status, neighborhood disadvantage, social support, negative affect/perceived stress, and three specific modifiable risk factors (i.e., overweight/obesity, insufficient physical activity, at-risk drinking). Findings indicated that neighborhood disadvantage, social support, and negative affect/perceived stress function as pathways linking socioeconomic status and modifiable risk factors among African American smokers, and negative affect/perceived stress appears to play a key mediating role. Policy, community, and individual-level interventions may attenuate the impact of socioeconomic status on health by targeting intermediate psychosocial, environmental, and behavioral pathways.
尽管社会经济地位是健康差异的一个主要影响因素，但社会经济地位影响健康的机制仍不清楚。本研究的目的是在一个寻求戒烟治疗的 399 名非裔美国人样本中，评估社会经济地位与可改变的健康风险因素之间的途径的先验概念模型。利用潜在变量建模方法来描述社会经济地位、邻里劣势、社会支持、负性情绪/感知压力与三种特定可改变的风险因素（即超重/肥胖、身体活动不足、危险饮酒）之间的相互关系。研究结果表明，邻里劣势、社会支持和负性情绪/感知压力是社会经济地位与非裔美国吸烟者可改变风险因素之间的途径，而负性情绪/感知压力似乎起着关键的中介作用。通过针对中间心理社会、环境和行为途径，政策、社区和个人层面的干预措施可能会减轻社会经济地位对健康的影响。
