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欧洲不同地区自评健康状况和非传染性疾病方面的职业不平等:来自欧洲社会调查(2014年)健康社会决定因素特别模块的研究结果

Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health.

作者信息

McNamara Courtney L, Toch-Marquardt Marlen, Balaj Mirza, Reibling Nadine, Eikemo Terje A, Bambra Clare

机构信息

Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway.

University of Siegen, Adolf-Reichwein-Str. 2, Siegen, Germany.

出版信息

Eur J Public Health. 2017 Feb 1;27(suppl_1):27-33. doi: 10.1093/eurpub/ckw223.

Abstract

BACKGROUND

Socioeconomic inequalities in the prevalence of non-communicable diseases (NCDs) are evident across European populations. Several previous studies have addressed the question of whether occupational inequalities in health differ across European regions. It is uncertain however, the degree to which occupational inequalities in NCDs are similar or dissimilar across different European regions.

METHODS

Using 2014 European Social Survey data from 20 countries, this article examines occupational inequalities in poor self-rated health (SRH) and 14 self-reported NCDs separately for women and men, by European region: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. Age-controlled adjusted risk ratios were calculated and separately compared a working class and intermediate occupational group with a salariat group.

RESULTS

Working class Europeans appear to have the highest risk of reporting poor SRH and a number of NCDs. We find inequalities in some NCDS to be the largest in the Northern region, suggesting further evidence of a Nordic paradox. Like some previous work, we did not find larger inequalities in poor SRH in the Central/East region. However, we did find the largest inequalities in this region for some NCDs. Our results do not align completely with previous work which finds smaller health inequalities in Southern Europe.

CONCLUSIONS

This work provides a first look at occupational inequalities across a range of NCDs for European men and women by region. Future work is needed to identify the underlying determinants behind regional differences.

摘要

背景

非传染性疾病(NCDs)患病率的社会经济不平等在欧洲人群中很明显。此前的几项研究探讨了欧洲不同地区健康方面的职业不平等是否存在差异。然而,目前尚不确定不同欧洲地区非传染性疾病的职业不平等在何种程度上相似或不同。

方法

本文使用来自20个国家的2014年欧洲社会调查数据,按欧洲地区分别考察了男性和女性在自我健康评价差(SRH)以及14种自我报告的非传染性疾病方面的职业不平等情况,这些疾病包括:心脏/循环系统问题、高血压、背痛、手臂/手部疼痛、足部/腿部疼痛、过敏、呼吸问题、胃部/消化问题、皮肤疾病、糖尿病、严重头痛、癌症、肥胖症和抑郁症。计算了年龄控制调整后的风险比,并分别将工人阶级和中等职业群体与工薪阶层群体进行比较。

结果

欧洲工人阶级报告自我健康评价差和多种非传染性疾病的风险似乎最高。我们发现,在北部地区,一些非传染性疾病的不平等最为严重,这进一步证明了北欧悖论。与之前的一些研究一样,我们没有发现在中东地区自我健康评价差方面存在更大的不平等。然而,我们确实发现该地区在一些非传染性疾病方面存在最大的不平等。我们的结果与之前发现南欧健康不平等较小的研究并不完全一致。

结论

这项工作首次按地区考察了欧洲男性和女性在一系列非传染性疾病方面的职业不平等情况。未来需要开展研究,以确定地区差异背后的潜在决定因素。

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