West P, Macintyre S, Annandale E, Hunt K
MRC Medical Sociology Unit, Glasgow, Scotland.
Soc Sci Med. 1990;30(6):665-73. doi: 10.1016/0277-9536(88)90252-3.
The assumption that social class inequalities in health are a persistent feature of the life-course has been questioned in a recent issue of this journal. On the evidence of mortality and chronic illness, the pattern in youth in Britain appears to be characterised by the lack of class differentials, a striking contrast to early adulthood where the familiar picture of health inequalities is observed. The possibility that this finding of relative equality in youth is a consequence of the limited, and potentially inappropriate, health indicators used has now been tested on a cohort of 15-year-olds in the West of Scotland. On a range of indicators, from subjective assessments to objective physical measures, very little evidence of class variation in health is found. The possible transience of the youth pattern is, however, indicated by findings from a cohort of 35-year-olds in the same study, among whom marked class gradients in health are apparent. Possible explanations for the transformation of a pattern of relative class equality in youth into one of inequalities in adulthood are discussed.
健康方面的社会阶层不平等是人生历程中一个持久特征的假设,在该期刊最近一期中受到了质疑。根据死亡率和慢性病的证据,英国年轻人中的模式似乎以缺乏阶层差异为特征,这与成年早期形成了鲜明对比,在成年早期可以观察到熟悉的健康不平等情况。年轻人相对平等这一发现是由于所使用的健康指标有限且可能不合适这一可能性,现在已经在苏格兰西部的一组15岁人群中进行了检验。在一系列指标上,从主观评估到客观身体测量,几乎没有发现健康方面存在阶层差异的证据。然而,同一研究中一组35岁人群的研究结果表明,年轻人这种模式可能是短暂的,在他们当中,健康方面明显存在显著的阶层梯度。文中讨论了年轻人相对阶层平等模式转变为成年期不平等模式的可能原因。