Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
Eur J Public Health. 2010 Dec;20(6):640-6. doi: 10.1093/eurpub/ckp200. Epub 2009 Dec 15.
An important gap in our knowledge of social inequalities in health is the former Yugoslavia, a region of culturally and historically diverse countries, with recent conflict. The aim of the present paper is to investigate relative and absolute inequalities in self-assessed health in former Yugoslavia (Bosnia-Herzegovina, Croatia, Kosovo, Macedonia, Montenegro, Slovenia and Serbia) by sex and education.
The data source is the South-East European Social Survey Project fielded in December 2003 to Winter 2004, covering the former Yugoslavia with a total sample of 18 481 respondents. Data from Slovenia were obtained from the 2004-wave of the European Social Survey. The health outcome variables were self-reported general health (SRH) and limiting longstanding illness (LLI).
Both absolute and relative educational health inequalities were present throughout the former Yugoslavia to a larger or lesser extent, although odds ratios (ORs) for LLI and SRH were not significant for Montenegrin women [LLI OR = 1.12, 95% confidence interval (CI): 0.92-1.37; SRH OR = 1.16, 95% CI: 0.96-1.40] and with respect to the reporting of LLI among Slovenian men (OR = 1.16, 95% CI: 0.96-1.44). Overall, Montenegro held the best position.
The prevalence of poor health and the degree of relative inequality in self-assessed health in the former Yugoslavian countries were similar in order to one another, and to other East European countries during the same period. Influences on subjective health require further elucidation. Further research should study a wider range of health outcomes using larger survey samples and a wider range of cultural and other predictor variables.
我们对健康方面社会不平等的认识存在一个重要的空白,那就是前南斯拉夫地区,该地区的国家文化和历史背景多样,并经历过近期冲突。本文旨在调查前南斯拉夫(波斯尼亚和黑塞哥维那、克罗地亚、科索沃、马其顿、黑山、斯洛文尼亚和塞尔维亚)中,性别和教育程度对自评健康的相对和绝对不平等现象。
本研究的数据来源于 2003 年 12 月至 2004 年冬季期间开展的东南欧社会调查项目,涵盖前南斯拉夫地区,总样本量为 18481 名受访者。来自斯洛文尼亚的数据则是通过 2004 年欧洲社会调查的第 5 波数据获得的。健康结果变量包括自评总体健康(SRH)和长期限制活动的疾病(LLI)。
在前南斯拉夫各地,无论程度大小,都存在绝对和相对的教育健康不平等现象,尽管在黑山女性中,LLI 和 SRH 的比值比(OR)没有统计学意义[LLI OR = 1.12,95%置信区间(CI):0.92-1.37;SRH OR = 1.16,95% CI:0.96-1.40],以及在斯洛文尼亚男性中,报告 LLI 的 OR 值为 1.16(95% CI:0.96-1.44)。总体而言,黑山的情况最好。
在前南斯拉夫各国,不良健康状况的流行程度和自评健康的相对不平等程度彼此相似,与同期其他东欧国家也相似。需要进一步阐明影响主观健康的因素。进一步的研究应使用更大的调查样本和更广泛的文化和其他预测变量来研究更广泛的健康结果。