Department of Epidemiology, University of Michigan, Ann Arbor, 48109-2029, USA.
Am J Epidemiol. 2011 Jan 15;173(2):192-200. doi: 10.1093/aje/kwq348. Epub 2010 Nov 8.
Epidemiologic studies seldom include wealth as a component of socioeconomic status. The authors investigated the associations between wealth and 2 broad outcome measures: mortality and self-rated general health status. Data from the longitudinal Panel Study of Income Dynamics, collected in a US population between 1984 and 2005, were used to fit marginal structural models and to estimate relative and absolute measures of effect. Wealth was specified as a 6-category variable: those with ≤0 wealth and quintiles of positive wealth. There were a 16%-44% higher risk and 6-18 excess cases of poor/fair health (per 1,000 persons) among the less wealthy relative to the wealthiest quintile. Less wealthy men, women, and whites had higher risk of poor/fair health relative to their wealthy counterparts. The overall wealth-mortality association revealed a 62% increased risk and 4 excess deaths (per 1,000 persons) among the least wealthy. Less wealthy women had between a 24% and a 90% higher risk of death, and the least wealthy men had 6 excess deaths compared with the wealthiest quintile. Overall, there was a strong inverse association between wealth and poor health status and between wealth and mortality.
流行病学研究很少将财富作为社会经济地位的一个组成部分。作者研究了财富与 2 种广泛的结果衡量标准之间的关联：死亡率和自我评估的一般健康状况。该研究使用了 1984 年至 2005 年期间在美国人群中进行的纵向收入动态面板研究的数据，拟合边缘结构模型并估计相对和绝对效应衡量标准。财富被指定为 6 类变量：财富≤0 的人群和正财富的五分位数。与最富有的五分位数相比，较不富裕的人群的健康状况较差/一般的风险高 16%-44%，不良健康状况的超额病例为 6-18 例（每 1000 人）。较不富裕的男性、女性和白人相对于其富有的同龄人，其健康状况较差/一般的风险更高。总体财富与死亡率的关联表明，最不富裕的人群的风险增加了 62%，每 1000 人中有 4 人死亡（每 1000 人）。与最富有的五分位数相比，较不富裕的女性的死亡风险高 24%-90%，而最不富裕的男性的死亡人数则比最富有的五分位数多 6 人。总体而言，财富与较差的健康状况和财富与死亡率之间存在很强的反比关系。
