中国自评健康的决定因素和社会经济差异。
Determinants of and socio-economic disparities in self-rated health in China.
机构信息
School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan, Hubei Province, 430070, People's Republic of China.
Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building,155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada.
出版信息
Int J Equity Health. 2017 Jan 11;16(1):7. doi: 10.1186/s12939-016-0496-4.
BACKGROUND
Self-rated health (SRH) is not only used to measure health status and health inequalities, but also as a strong predictor of morbidity and mortality. The purpose of this study was to: 1) evaluate the factors that account for variations in self-rated health among Chinese citizens; and to 2) explore the process through which socio-economic status may impact self-rated health.
METHODS
Data were derived from the Chinese General Social Survey (CGSS) (2013). Determinants of self-rated health were analyzed along four main dimensions: demographic characteristics, socio-economic status, lifestyle, and psychosocial factors. Multivariate odds ratios for good self-rated health were calculated for different variables in order to analyze the determinants. Binary logistic regression analysis was performed to assess the extent to which lifestyle and psychosocial factors explained the association between socio-economic status and self-rated health.
RESULTS
About 65% of the survey respondents reported good self-rated health. Women, the elderly, married or single respondents and residents of Western China were less likely to report good self-rated health. Respondents who were engaged in work, had higher household income, reported high social class and higher socio-economic status compared with peers were more likely to report good self-rated health. Normal weight and physically active respondents along with those reporting a happy life, no depression, and good relationships with families and friends were related to good self-rated health. We also found the effect of socio-economic status on self-rated health was partly explained by lifestyle and psychosocial factors.
CONCLUSION
The present findings support the notion that both socio-economic status and lifestyle as well as psychosocial factors were related with good self-rated health. The interventions targeting these factors could improve the health status of the population. The depression was the most influential predictor of self-rated health, especially for the women and the elderly. Although lifestyle and psychosocial factors explained partly the the association between socio-economic status and health, the reason why socio-economic difference exists in health must be further explored. What's more, it needs to be further studied why the same determinant has different influence strengths on the health of different groups of people.
背景
自评健康（SRH）不仅用于衡量健康状况和健康不平等，还可作为发病率和死亡率的强有力预测指标。本研究的目的是：1）评估导致中国公民自评健康状况差异的因素；2）探讨社会经济地位影响自评健康的过程。
方法
数据来自中国综合社会调查（CGSS）（2013 年）。从人口统计学特征、社会经济地位、生活方式和心理社会因素四个主要方面分析了自评健康的决定因素。为了分析决定因素，针对不同变量计算了良好自评健康的多变量优势比。采用二元逻辑回归分析来评估生活方式和心理社会因素在多大程度上解释了社会经济地位与自评健康之间的关联。
结果
大约 65%的调查对象报告了良好的自评健康状况。女性、老年人、已婚或单身受访者以及中国西部的居民不太可能报告良好的自评健康状况。与同龄人相比，从事工作、家庭收入较高、社会阶层较高和社会经济地位较高的受访者更有可能报告良好的自评健康状况。体重正常、身体活跃、生活幸福、没有抑郁、与家人和朋友关系良好的受访者与良好的自评健康状况有关。我们还发现，社会经济地位对自评健康的影响部分可以通过生活方式和心理社会因素来解释。
结论
本研究结果支持以下观点，即社会经济地位以及生活方式和心理社会因素与良好的自评健康状况有关。针对这些因素的干预措施可以改善人群的健康状况。抑郁是自评健康的最具影响力的预测因素，尤其是对女性和老年人。虽然生活方式和心理社会因素部分解释了社会经济地位与健康之间的关联，但社会经济差异存在的原因仍需进一步探讨。更重要的是，需要进一步研究为什么同一决定因素对不同人群的健康有不同的影响强度。
Zotero 插件