Muntaner C, Davis O, McIsaack K, Kokkinen L, Shankardass K, O'Campo P
1 Bloomberg Faculty of Nursing and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
2 School of Social Policy, Sociology and Social Research, University of Kent, UK.
Int J Health Serv. 2017 Jul;47(3):410-431. doi: 10.1177/0020731417712509. Epub 2017 Jun 26.
This article builds on recent work that has explored how welfare regimes moderate social class inequalities in health. It extends research to date by using longitudinal data from the EU-SILC (2003-2010) and examines how the relationship between social class and self-reported health and chronic conditions varies across 23 countries, which are split into five welfare regimes (Nordic, Anglo-Saxon, Eastern, Southern, and Continental). Our analysis finds that health across all classes was only worse in Eastern Europe (compared with the Nordic countries). In contrast, we find evidence that the social class gradient in both measures of health was significantly wider in the Anglo-Saxon and Southern regimes. We suggest that this evidence supports the notion that welfare regimes continue to explain differences in health according to social class location. We therefore argue that although downward pressures from globalization and neoliberalism have blurred welfare regime typologies, the Nordic model may continue to have an important mediating effect on class-based inequalities in health.
本文基于近期探索福利制度如何缓和健康方面社会阶层不平等的研究。它通过使用欧盟收入与生活条件调查（2003 - 2010年）的纵向数据扩展了迄今为止的研究，并考察了社会阶层与自我报告的健康及慢性病状况之间的关系在23个国家中是如何变化的，这些国家被划分为五种福利制度（北欧、盎格鲁 - 撒克逊、东欧、南欧和大陆）。我们的分析发现，所有阶层的健康状况仅在东欧比北欧国家差。相比之下，我们发现有证据表明，在盎格鲁 - 撒克逊和南欧福利制度下，健康状况这两项指标中的社会阶层梯度显著更大。我们认为，这一证据支持了福利制度继续根据社会阶层位置来解释健康差异这一观点。因此，我们认为尽管全球化和新自由主义带来的下行压力使福利制度类型变得模糊，但北欧模式可能继续对基于阶层的健康不平等产生重要的调节作用。
