Moor I, Pförtner T K, Lampert T, Ravens-Sieberer U, Richter M
Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther Universität Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale).
Gesundheitswesen. 2012 Jul;74 Suppl:S49-55. doi: 10.1055/s-0032-1312633. Epub 2012 Jul 26.
Health is strongly linked to social position. Several studies showed consistent or increasing health inequalities in the last decades. So far, few studies focused on trends in social inequalities in health among children and adolescents. The objective of this study was to determine changes in socioeconomic differences in subjective health between 2002 and 2010 of 11- to 15-year-old students in Germany.Data were obtained from the German part of the cross-sectional WHO "Health Behaviour in School-aged Children" survey in 2002 (n=5.221), 2006 (n=6.896) and 2010 (n=4.723). Log binomial regression models were used to assess the extent of inequalities in self-rated health across the survey years. Socioeconomic position was measured using the family affluence scale (FAS) and perceived family wealth.A relatively small improvement in good/excellent self-rated health was observed in both boys and girls from 2002 (85.2%) to 2010 (87%). Despite this improvement, inequalities in self-rated health could be identified for all survey years, regardless of which socioeconomic indicator was used (RR 1.4 up to 1.8). The level of these differences remained virtually unchanged in girls and boys in that time period.The same relationship of family affluence, family wealth and self-rated health has persisted for almost a decade in Germany. Recent strategies could not tackle existing inequalities in self-rated health which indicates an increasing need to develop and implement innovative measures and to intensify efforts of social and health policy.
健康与社会地位紧密相连。多项研究表明,在过去几十年中,健康不平等现象持续存在或有所加剧。到目前为止,很少有研究关注儿童和青少年健康方面社会不平等的趋势。本研究的目的是确定2002年至2010年德国11至15岁学生主观健康方面社会经济差异的变化。
数据来自世界卫生组织“学龄儿童健康行为”横断面调查的德国部分,分别于2002年(n = 5221)、2006年(n = 6896)和2010年(n = 4723)收集。使用对数二项回归模型评估各调查年份自我评定健康方面不平等的程度。社会经济地位通过家庭富裕程度量表(FAS)和感知家庭财富来衡量。
从2002年(85.2%)到2010年(87%),男孩和女孩自我评定为良好/优秀健康状况的比例都有相对较小的改善。尽管有这种改善,但在所有调查年份中,无论使用哪种社会经济指标,都能发现自我评定健康方面的不平等(相对危险度为1.4至1.8)。在这一时期,男孩和女孩的这些差异水平几乎没有变化。
在德国,家庭富裕程度、家庭财富与自我评定健康之间的这种关系已经持续了近十年。近期的策略未能解决自我评定健康方面现有的不平等问题,这表明越来越需要制定和实施创新措施,并加强社会和卫生政策方面的努力。