van Zon Sander K R, Bültmann Ute, Mendes de Leon Carlos F, Reijneveld Sijmen A
Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9700 AD, Groningen, The Netherlands.
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, Michigan, The United States of America.
PLoS One. 2015 Dec 30;10(12):e0145947. doi: 10.1371/journal.pone.0145947. eCollection 2015.
The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender.
The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender.
Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups.
Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and health outcome, as findings on socioeconomic health inequalities may differ between them.
社会经济健康不平等的程度在不同年龄组中存在差异。目前尚不清楚社会经济健康不平等是否会因其他已知影响社会经济地位与健康关系的因素(如社会经济地位指标、健康结果、性别)在不同年龄组中有所不同,也不清楚社会经济健康不平等是按绝对还是相对指标来衡量。目的是研究绝对和相对社会经济健康不平等是否会因社会经济地位指标、健康结果和性别在不同年龄组中存在差异。
研究样本来自生命线队列研究的基线测量,包括95432名参与者。社会经济地位通过教育水平和家庭收入来衡量。身心健康状况采用兰德36项健康调查量表进行测量。年龄分为11个5岁年龄组。通过比较均值来检验绝对不平等。通过比较基尼系数来检验相对不平等。分别按教育水平和家庭收入对两种健康结果进行分析。对所有年龄组进行分析,并按性别分层。
绝对和相对社会经济健康不平等因社会经济地位指标、健康结果和性别在不同年龄组中存在差异。家庭收入方面,心理健康的绝对不平等最为明显。在较年轻年龄组中比在较年长年龄组中更大。教育水平方面,身体健康的相对不平等最为明显。基尼系数在年轻年龄组中最大,在年长年龄组中最小。
绝对和相对社会经济健康不平等在横断面研究中因社会经济地位指标、健康结果和性别在不同年龄组中存在差异。除了社会经济地位指标和健康结果外,研究人员在选择特定年龄组时应审慎考虑其影响,因为不同年龄组关于社会经济健康不平等的研究结果可能存在差异。