Illsley R, Baker D
School of Social Sciences, University of Bath, England.
Soc Sci Med. 1991;32(4):359-65. doi: 10.1016/0277-9536(91)90336-b.
The meaning of inequality in health is contextually determined; it changes both within and between countries and over time. This paper points to the limited ability of the classic class-based analyses of inequalities in health to explain such change. An alternative form of analysis, based on the interaction between age, gender and cause of death is proposed. Within this framework, intercountry (European) comparisons of life expectancy and age-specific mortality for both sexes are used to illustrate a shift over time in the social aetiology of disease from economic to behaviourally based causality. Implications for the British experience and for British social policy are discussed.
健康不平等的含义是由具体背景决定的；它在不同国家内部和国家之间以及随着时间的推移都会发生变化。本文指出，基于经典阶层的健康不平等分析在解释这种变化方面能力有限。本文提出了一种基于年龄、性别和死因之间相互作用的替代分析形式。在此框架内，通过对欧洲国家男女预期寿命和特定年龄死亡率的跨国比较，来说明疾病的社会病因随着时间的推移从基于经济因素向基于行为因素的因果关系转变。文中还讨论了这一转变对英国情况及英国社会政策的影响。
