Oude Groeniger Joost, van Lenthe Frank J
Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.
J Epidemiol Community Health. 2016 Oct;70(10):1045-8. doi: 10.1136/jech-2016-207642. Epub 2016 Jul 11.
A higher prevalence of unhealthy behaviours in lower socioeconomic groups contributes to socioeconomic inequalities in mortality. Recent cohort studies suggest that the contribution of health behaviours to socioeconomic inequalities in mortality is larger when measured repeatedly over time ('time-varying') instead of once only ('time-fixed'). Explanations for a larger contribution of health behaviours, however, are hardly discussed in the current literature, and appear to be more complex than a widening of inequalities in health behaviours over time alone. We describe the use of time-varying health behaviours to examine socioeconomic inequalities in mortality, systematically listing underlying mechanisms that may cause differences between time-varying and time-fixed models, and show that these mechanisms may be specific for each health behaviour. The use of time-varying health behaviours advances our understanding of the explanation of socioeconomic inequalities in mortality, but underlying mechanisms must be carefully examined.
社会经济地位较低群体中不健康行为的患病率较高，这导致了死亡率方面的社会经济不平等。近期的队列研究表明，与仅进行一次测量（“时间固定”）相比，随着时间反复测量（“随时间变化”）时，健康行为对死亡率方面社会经济不平等的影响更大。然而，当前文献中几乎没有讨论健康行为影响更大的原因，而且其原因似乎比仅仅是健康行为不平等随时间扩大更为复杂。我们描述了如何使用随时间变化的健康行为来研究死亡率方面的社会经济不平等，系统地列出了可能导致随时间变化模型和时间固定模型之间差异的潜在机制，并表明这些机制可能因每种健康行为而异。使用随时间变化的健康行为增进了我们对死亡率方面社会经济不平等原因的理解，但必须仔细研究潜在机制。
