Department of Psychiatry, University of California, San Francisco, CA, USA.
Ann N Y Acad Sci. 2010 Feb;1186:5-23. doi: 10.1111/j.1749-6632.2009.05337.x.
Over the past two decades, exponential growth of empirical research has fueled markedly increased concern about health disparities. In this paper, we show the progression of research on socioeconomic status (SES) and health through several eras. The first era reflected an implicit threshold model of the association of poverty and health. The second era produced evidence for a graded association between SES and health where each improvement in education, income, occupation, or wealth is associated with better health outcomes. Moving from description of the association to exploration of pathways, the third era focused on mechanisms linking SES and health, whereas the fourth era expanded on mechanisms to consider multilevel influences, and a fifth era added a focus on interactions among factors, not just their main effects or contributions as mediators. Questions from earlier eras remain active areas of research, while later eras add depth and complexity.
在过去的二十年中，实证研究的指数级增长引发了人们对健康差异的极大关注。在本文中，我们展示了社会经济地位（SES）与健康相关研究在几个时代的发展历程。第一个时代反映了贫困与健康关联的隐含阈值模型。第二个时代提供了 SES 与健康之间存在梯度关联的证据，即教育、收入、职业或财富的每一次提高都与更好的健康结果相关。从关联的描述到途径的探索，第三个时代专注于将 SES 与健康联系起来的机制，而第四个时代则扩展到了考虑多层次影响的机制，并在第五个时代增加了对因素之间相互作用的关注，而不仅仅是它们作为中介的主要影响或贡献。早期时代的问题仍然是研究的活跃领域，而后期时代则增加了深度和复杂性。
