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阶级关系与全因死亡率:基于巴塞罗那 2000 年健康访谈调查对赖特阶级方案的检验

Class relations and all-cause mortality: a test of Wright's social class scheme using the Barcelona 2000 Health Interview Survey.

机构信息

Faculty of Nursing, Dalla Lana School of Public Health, Department of Psychiatry, University of Toronto.

出版信息

Int J Health Serv. 2011;41(3):431-58. doi: 10.2190/HS.41.3.c.

Abstract

The aim of this study is to test the effects of neo-Marxian social class and potential mediators such as labor market position, work organization, material deprivation, and health behaviors on all-cause mortality. The authors use longitudinal data from the Barcelona 2000 Health Interview Survey (N=7526), with follow-up interviews through the municipal census in 2008 (95.97% response rate). Using data on relations of property, organizational power, and education, the study groups social classes according to Wright's scheme: capitalists, petit bourgeoisie, managers, supervisors, and skilled, semi-skilled, and unskilled workers. Findings indicate that social class, measured as relations of control over productive assets, is an important predictor of mortality among working-class men but not women. Workers (hazard ratio = 1.60; 95% confidence interval, 1.10-2.35) but also managers and small employers had a higher risk of death compared with capitalists. The extensive use of conventional gradient measures of social stratification has neglected sociological measures of social class conceptualized as relations of control over productive assets. This concept is capable of explaining how social inequalities are generated. To confirm the protective effect of the capitalist class position and the "contradictory class location hypothesis," additional efforts are needed to properly measure class among low-level supervisors, capitalists, managers, and small employers.

摘要

本研究旨在检验新马克思主义社会阶级以及潜在的中介因素(如劳动力市场地位、工作组织、物质剥夺和健康行为)对全因死亡率的影响。作者使用了来自巴塞罗那 2000 年健康访谈调查(N=7526)的纵向数据,并通过 2008 年的市议会人口普查进行了后续访谈(95.97%的回应率)。该研究根据赖特的方案,使用财产关系、组织权力和教育数据,将社会阶级分为资本家、小资产阶级、经理、主管和熟练、半熟练和非熟练工人。研究结果表明,作为对生产性资产控制关系的衡量标准,社会阶级是男性工人阶级死亡率的重要预测因素,但对女性工人阶级死亡率则不然。工人(危险比=1.60;95%置信区间,1.10-2.35),以及经理和小雇主的死亡风险也高于资本家。传统的广泛使用的社会分层的梯度衡量标准忽略了社会学中对生产性资产控制关系的社会阶级的概念性衡量标准。这一概念能够解释社会不平等是如何产生的。为了确认资本家阶级地位的保护作用和“矛盾阶级定位假说”,需要进一步努力,正确衡量低级别主管、资本家、经理和小雇主之间的阶级。

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