Hurrelmann K, Richter M, Rathmann K
Universität Bielefeld und Hertie School of Governance Berlin.
Gesundheitswesen. 2011 Jun;73(6):335-43. doi: 10.1055/s-0030-1265195. Epub 2011 Mar 8.
In all highly developed countries, the overall health status of the population has significantly improved within the past 30 years. The most important reason for this is the increase in economic prosperity. Economic wealth, however, today is much more unequally distributed than it was 3 decades ago. Countries with relatively small disparities in the availability of material resources between socioeconomic groups, such as the Scandinavian countries, have better health outcomes on the population level. Health inequalities, however, have also reached a higher level than 30 years ago. As of today, we do not have convincing explanations for the interrelation of economic and health inequality. This paper gives an overview of existing research on a comparative basis. The research results are ambivalent. They show the puzzling result that the Scandinavian countries with their highly distributive welfare policy manage to achieve the comparatively highest level of economic, but not health, equity. Based on these results, we develop proposals for future research approaches. A central assumption is that in rich societies no longer only material, but more and more immaterial determinants are crucial for the formation of health inequality. The promotion of "salutogenic" self-management capabilities in socially disadvantaged groups is considered to be the central element in effective intervention strategies.
在所有高度发达国家，过去30年里民众的总体健康状况有了显著改善。最重要的原因是经济繁荣程度的提高。然而，如今经济财富的分配比30年前更加不平等。在社会经济群体之间物质资源可得性差异相对较小的国家，如斯堪的纳维亚国家，在人口层面有更好的健康结果。然而，健康不平等也比30年前达到了更高水平。截至目前，我们对经济不平等与健康不平等之间的相互关系尚无令人信服的解释。本文在比较的基础上对现有研究进行了概述。研究结果是矛盾的。它们显示了一个令人困惑的结果，即拥有高度分配性福利政策的斯堪的纳维亚国家设法实现了相对最高水平的经济公平，但并非健康公平。基于这些结果，我们为未来的研究方法提出了建议。一个核心假设是，在富裕社会中，对健康不平等形成至关重要的不再仅仅是物质因素，而是越来越多的非物质因素。在社会弱势群体中促进“健康生成性”自我管理能力被认为是有效干预策略的核心要素。
