Universitat Pompeu Fabra, Barcelona, Spain.
Womens Health Issues. 2012 Sep;22(5):e483-90. doi: 10.1016/j.whi.2012.07.001.
This study analyzes health inequalities among older adults in Spain by adopting a conceptual framework that globally considers two dimensions of health determinants (gender and the socioeconomic development of the region of residence) and the mediating influence of social support, taking into account individual socioeconomic position.
Data came from the 2006 Spanish National Health Interview Survey. A subsample of people aged 65 to 85 years with no paid work living in two socioeconomically developed regions situated in the north of Spain and in two less developed ones situated in the south was selected. The health outcomes analyzed were self-rated health status and poor mental health status. Multiple logistic regression models were fitted and covariates (age, socioeconomic position, household type, and social support) were added in subsequent steps.
Self-rated health status among older adults was poorer in the less socioeconomically developed regions, but especially among women, whereas the poorest mental health status was found in one of the most socioeconomically developed regions, especially for men. Social support was an important determinant of health status, regardless of the socioeconomic development of the region. Gender inequalities in health did not differ by regional socioeconomic development with one exception regarding poor self-rated health.
These results show the importance of implementing stronger gender equity policies, as well as reducing socioeconomic inequalities among regions and strengthen social support among older adults.
本研究通过采用一个综合框架来分析西班牙老年人的健康不平等现象,该框架全局考虑了健康决定因素的两个维度(性别和居住地区的社会经济发展)以及社会支持的中介影响,同时考虑了个体的社会经济地位。
数据来自 2006 年西班牙国家健康访谈调查。选择了居住在西班牙北部两个社会经济发达地区和南部两个欠发达地区、年龄在 65 至 85 岁之间、没有带薪工作的老年人作为子样本。分析的健康结果是自我评估的健康状况和心理健康状况不佳。拟合了多个逻辑回归模型,并在后续步骤中加入了协变量(年龄、社会经济地位、家庭类型和社会支持)。
在社会经济欠发达地区,老年人的自我评估健康状况较差,但女性更为明显,而在最发达的地区之一,男性的心理健康状况最差。社会支持是健康状况的一个重要决定因素,与地区社会经济发展无关。除了自我评估健康状况不佳这一例外,健康方面的性别不平等在不同地区的社会经济发展方面没有差异。
这些结果表明,实施更强有力的性别平等政策以及减少地区间的社会经济不平等和加强老年人的社会支持非常重要。