Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
Prev Chronic Dis. 2010 Jul;7(4):A74. Epub 2010 Jun 15.
Increasing research and policy attention is being given to how the socioeconomic environment influences health. This article discusses potential indicators or metrics regarding the socioeconomic environment that could play a role in an incentive-based system for population health. Given the state of the research regarding the influence of socioeconomic contextual variables on health outcomes, the state of data and metrics for these variables at the local level, and the potential for program and policy intervention, we recommend a set of metrics related to the socioeconomic composition of a community (including poverty, unemployment, and public assistance rates); educational attainment and achievement; racial segregation; and social-capital indicators such as density of voluntary organizations and voter turnout. These indicators reflect the evidence that population health gains depend on improvements in many of the fundamental social determinants of health, including meaningful employment, income security, educational opportunities, and engaged, active communities.
越来越多的研究和政策关注集中于社会经济环境如何影响健康。本文讨论了一些关于社会经济环境的潜在指标或衡量标准,这些指标或衡量标准可能在基于激励的人口健康系统中发挥作用。考虑到社会经济背景变量对健康结果影响的研究状况、这些变量在地方层面的数据和衡量标准状况,以及计划和政策干预的可能性,我们建议采用一系列与社区社会经济构成(包括贫困率、失业率和公共援助率)、教育程度和成就、种族隔离以及社会资本指标(如志愿组织密度和选民投票率)相关的指标。这些指标反映了这样一种证据,即人口健康的提高取决于许多基本的健康决定因素的改善,包括有意义的就业、收入保障、教育机会以及积极参与和活跃的社区。