Health Inequalities Research Group, Employment Conditions Network, Universitat Pompeu Fabra, Estació de França, Passeig de Circumval-Lació, Barcelona, Spain.
Int J Health Serv. 2011;41(3):459-82. doi: 10.2190/HS.41.3.d.
Surveillance of social determinants of health inequalities is an essential but still underdeveloped issue in public health. Existing research has identified unemployment as an important social determinant of health inequalities. This cross-sectional study investigates the impact of unemployment on mental health outcomes among vulnerable groups, using the 2006 Catalonian Health Survey (N=8591). The authors estimate the prevalence ratios and differences (excess of prevalence) for poor mental health in the unemployed and employed, with 95 percent confidence intervals. After taking into account the interactions among social mechanisms of inequality and related factors, the authors identified seven vulnerable groups to monitor. Primary findings indicate that unemployment has a greater adverse effect on the mental health of male manual workers, single mothers, main-earner women, and manual workers without unemployment benefits for both sexes. Findings support the need to devote more research to the surveillance of unemployment as a social determinant of health inequalities, to identify additional unemployment indicators, and to consider how various social mechanisms of inequality interact with each other to produce health inequalities among vulnerable groups.
监测健康不平等的社会决定因素是公共卫生中一个必不可少但仍欠发达的问题。现有研究已经确定失业是健康不平等的一个重要社会决定因素。本横断面研究使用 2006 年加泰罗尼亚健康调查（N=8591）调查了失业对弱势群体心理健康结果的影响。作者估计了失业和就业人群中心理健康状况不佳的流行率比和差异（流行率过剩），置信区间为 95%。在考虑到不平等的社会机制和相关因素之间的相互作用后，作者确定了需要监测的七个弱势群体。主要发现表明，失业对男性体力劳动者、单身母亲、女性主要收入者以及男女体力劳动者中没有失业救济金的人群的心理健康有更大的不利影响。研究结果支持需要投入更多的研究来监测失业作为健康不平等的社会决定因素，以确定其他失业指标，并考虑各种不平等的社会机制如何相互作用，从而在弱势群体中产生健康不平等。
