Harvard University, Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA.
J Health Soc Behav. 2013 Jun;54(2):166-82. doi: 10.1177/0022146513481230. Epub 2013 May 30.
Over the past half century the gap in mortality across education levels has grown in the United States, and since the mid-1980s, the growth has been especially pronounced among white women. The reasons for the growth among white women are unclear. We investigated three explanations-social-psychological factors, economic circumstances, and health behaviors-for the widening education gap in mortality from 1997 to 2006 among white women aged 45 to 84 years using data from the National Health Interview Survey Linked Mortality File (N = 46,744; 4,053 deaths). Little support was found for social-psychological factors, but economic circumstances and health behaviors jointly explained the growing education gap in mortality to statistical nonsignificance. Employment and smoking were the most important individual components. Increasing high school graduation rates, reducing smoking prevalence, and designing work-family policies that help women find and maintain desirable employment may reduce mortality inequalities among women.
在过去的半个世纪里,美国受教育程度不同的人群之间的死亡率差距一直在扩大,自 20 世纪 80 年代中期以来,这种差距在白人女性中尤为明显。白人女性死亡率差距扩大的原因尚不清楚。我们利用国家健康访谈调查与死亡档案的数据(N=46744;4053 例死亡),从社会心理因素、经济环境和健康行为三个方面,研究了 1997 年至 2006 年间 45 岁至 84 岁白人女性中,受教育程度不同导致死亡率差距扩大的原因。研究结果几乎不支持社会心理因素的解释,但经济环境和健康行为共同解释了导致死亡率差距不断扩大的原因,达到了统计学上的无显著差异。就业和吸烟是最重要的个体因素。提高高中毕业生比例、降低吸烟率以及制定帮助女性找到并维持理想工作的工作家庭政策,可能会减少女性之间的死亡率不平等。