Department of Population Studies, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
BMC Public Health. 2011 May 25;11:390. doi: 10.1186/1471-2458-11-390.
In developed countries with old age structures most deaths occur at older ages and older people account for the majority of those in poor health, which suggests a particular need to investigate health inequalities in the older population.
We empirically compared the materialist, psychosocial and lifestyle/behavioural theoretical mechanisms of explanation for socio-economic variation in health using data from two waves of the English Longitudinal Study of Ageing (ELSA), a nationally representative multi-purpose sample of the population aged 50 and over living in England. Three dimensions of health were examined: somatic health, depression and well-being.
The materialist and lifestyle/behavioural paths had the most prominent mediating role in the association between socio-economic position and health in the older population, whereas the psychosocial pathway was less influential and exerted most of its influence on depression and well-being, with part of its effect being due to the availability of material resources.
From a policy perspective there is therefore an indication that population interventions to reduce health differentials and thus improve the overall health of the older population should focus on material circumstances and population based interventions to promote healthy lifestyles.
在人口老龄化程度较高的发达国家，大多数死亡发生在高龄人群，而健康状况不佳的人群中老年人占多数，这表明特别需要调查老年人中的健康不平等现象。
我们使用来自英国老龄化纵向研究（ELSA）的两波数据，实证比较了物质主义、心理社会和生活方式/行为理论解释社会经济健康差异的机制，ELSA 是英格兰 50 岁及以上人群的全国代表性多用途样本。研究考察了三个健康维度：躯体健康、抑郁和幸福感。
在老年人群中，物质主义和生活方式/行为途径在社会经济地位与健康之间的关联中具有最突出的中介作用，而心理社会途径的影响较小，对抑郁和幸福感的影响最大，其部分影响归因于物质资源的可用性。
因此，从政策角度来看，有迹象表明，旨在减少健康差异从而改善老年人口整体健康的人群干预措施应侧重于物质环境和以人群为基础的干预措施，以促进健康的生活方式。
