Ishikawa Yoshiki, Kondo Naoki, Kawachi Ichiro, Viswanath Kasisomayajula
Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Cancer Scan, Shibuya-ku, Tokyo, Japan.
Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Patient Educ Couns. 2016 Nov;99(11):1803-1807. doi: 10.1016/j.pec.2016.05.018. Epub 2016 May 28.
Communication inequality has been offered as one potential mechanism through which social determinants influence multiple health behaviors. The purpose of this study was to examine the underlying mechanisms between communication inequality and health behaviors.
Data from a nationally representative cross-sectional survey of 18,426 people aged 18 years and above in the United States were used for secondary analysis. Measures included socio-demographic characteristics, social participation (structural social capital), health media use (TV, print, and the Internet), and five health behaviors (physical activity, cigarette smoking, alcohol use, and intake of fruit and vegetable). Path analysis was performed to examine the linkages between social determinants, health media use, social participation, and social gradients in health behaviors.
Path analysis revealed that socioeconomic gradients in health behaviors is mediated by: 1) inequalities in health media use; 2) disparities in social participation, which leads to differential media use; and 3) disparities in social participation that are not mediated by media use.
Consistent with the theory of communication inequality, socioeconomic disparities in media use partially mediate disparities in multiple health behaviors.
To address health inequalities, it is important to utilize health media to target populations with low socioeconomic statuses.
沟通不平等被认为是社会决定因素影响多种健康行为的一种潜在机制。本研究旨在探讨沟通不平等与健康行为之间的潜在机制。
来自美国全国代表性的18426名18岁及以上人群横断面调查的数据用于二次分析。测量指标包括社会人口学特征、社会参与（结构性社会资本）、健康媒体使用（电视、印刷品和互联网）以及五种健康行为（体育活动、吸烟、饮酒以及水果和蔬菜摄入量）。进行路径分析以检验社会决定因素、健康媒体使用、社会参与和健康行为社会梯度之间的联系。
路径分析表明，健康行为中的社会经济梯度由以下因素介导：1）健康媒体使用不平等；2）社会参与差异，这导致了不同的媒体使用；3）不由媒体使用介导的社会参与差异。
与沟通不平等理论一致，媒体使用中的社会经济差异部分介导了多种健康行为的差异。
为解决健康不平等问题，利用健康媒体针对社会经济地位较低人群很重要。
