Department of Geography, Wolfson Research Institute, Durham University, Stockton on Tees, United Kingdom.
Int J Health Serv. 2010;40(3):399-420. doi: 10.2190/HS.40.3.b.
This article uses data from three waves of the European Social Survey (2002, 2004, 2006) to compare educational inequalities in self-reported health (good vs. bad) and limiting longstanding illness in six age groups based on decade of birth (1930s-1980s) in 17 countries, categorized into four welfare state regimes (Anglo-Saxon, Bismarckian, Scandinavian, Southern). The authors hypothesized that health inequalities in these age groups would vary because of their different welfare state experiences-welfare state regime life courses-both temporally, in terms of different phases of welfare state development (inequalities smaller among older people), and spatially, in terms of welfare state regime type (inequalities smaller among older Scandinavians). The findings are that inequalities in health tended to increase, not decrease, with age. Similarly, inequalities in health were not smallest in the Scandinavian regime or among the older Scandinavian cohorts. In keeping with the rest of the literature, the Bismarckian and Southern regimes had smaller educational inequalities in health. Longitudinal analysis that integrates wider public health factors or makes smaller comparisons may be a more productive way of analyzing cross-national variations in health inequalities and their relationship to welfare state life courses.
本文使用了来自欧洲社会调查（2002 年、2004 年、2006 年）的三波数据，比较了在 17 个国家中，基于出生十年期（20 世纪 30 年代至 80 年代）的六个年龄组中，受教育程度不同对自报健康状况（良好与不佳）和长期患病的限制的不平等现象，这些国家分为四种福利国家模式（盎格鲁-撒克逊模式、俾斯麦模式、斯堪的纳维亚模式、南欧模式）。作者假设，由于不同的福利国家经历（福利国家模式的人生轨迹），这些年龄组中的健康不平等现象会有所不同——无论是在时间上，还是在福利国家发展的不同阶段（老年人的不平等程度较小），还是在空间上，即福利国家模式的类型（老年人的不平等程度较小）。研究结果表明，健康不平等现象往往会随着年龄的增长而增加，而不是减少。同样，在斯堪的纳维亚模式或年龄较大的斯堪的纳维亚人群中，健康不平等现象并不是最小的。与文献的其余部分一致，俾斯麦模式和南欧模式的健康方面的教育不平等程度较小。综合更广泛的公共卫生因素或进行更小比较的纵向分析，可能是分析健康不平等现象及其与福利国家人生轨迹之间关系的更具成效的方法。
