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发展中国家最贫困和最富裕五分之一人口之间的健康差距以及健康差距的社会背景。

Health disparities and the social context of health disparity between the poorest and wealthiest quintiles in a developing country.

作者信息

Bourne Paul

机构信息

Socio-Medical Research Institute, Kingston, Jamaica.

出版信息

J Health Care Poor Underserved. 2011 May;22(2):532-48. doi: 10.1353/hpu.2011.0055.

Abstract

BACKGROUND

Previous studies that have examined social determinants of health have done so for the general population or elderly, but none have explored socio-biological determinants between the poorest and wealthiest income quintiles. More specifically, health disparity and socio-biological determinants of the poorest quintile and the wealthiest quintile have never been examined for Jamaica.

OBJECTIVES

The current study will bridge this gap in the literature by examining health status, illness, age at which the lower and upper classes indicate having illness and particular illnesses, and parameters that explain health status of the upper and lower quintiles in Jamaica as well as the social context of disparities between the two groups.

METHODS

A sample of 2,725 respondents from the wealthiest quintile and poorest quintile was extracted from a cross-sectional survey of 6,783 respondents. Stepwise logistic regression was used to determine the contribution of significant socio-biological determinants of the health status model. Health status here corresponds to self-rated general health of respondents.

RESULTS

The wealthiest quintile reported good health status 62% more than for the poorest quintile.

CONCLUSION

This study is far-reaching and can be used to lessen the health disparities between and among social hierarchies in Jamaica. Health policies in Jamaica must be adopted that will address the social determinants of health. They should aim at making the health system more effective in reaching the poorest in the nation, especially those in rural areas.

摘要

背景

以往研究健康的社会决定因素时,针对的是普通人群或老年人,但尚无研究探讨最贫困和最富裕收入五分位数人群之间的社会生物学决定因素。更具体地说,牙买加从未对最贫困五分位数人群和最富裕五分位数人群的健康差距及社会生物学决定因素进行过研究。

目的

本研究将通过调查牙买加最贫困和最富裕五分位数人群的健康状况、疾病情况、上下层阶级表示患病的年龄及特定疾病,以及解释这两组人群健康状况的参数和两组之间差距的社会背景,填补文献中的这一空白。

方法

从对6783名受访者的横断面调查中抽取了2725名来自最富裕五分位数和最贫困五分位数的受访者作为样本。采用逐步逻辑回归来确定健康状况模型中重要社会生物学决定因素的作用。这里的健康状况对应受访者的自我评定总体健康状况。

结果

最富裕五分位数人群报告的健康状况良好的比例比最贫困五分位数人群高出62%。

结论

本研究影响深远,可用于缩小牙买加社会阶层之间的健康差距。牙买加必须制定健康政策,解决健康的社会决定因素问题。这些政策应旨在使卫生系统更有效地惠及该国最贫困人群,尤其是农村地区的贫困人口。

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