Pampel Fred C, Bricard Damien, Khlat Myriam, Legleye Stéphane
Institute of Behavioral Science, University of Colorado, Boulder, 80309-0483 USA.
Institut de Recherche et Documentation en Economie de la Santé (IRDES), Paris, France.
Popul Res Policy Rev. 2017 Jun;36(3):309-330. doi: 10.1007/s11113-016-9424-y. Epub 2017 Jan 9.
Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the United States) using smoking history measures from the 2010 French Health Barometer (N = 20,940) and the 2010 U.S. National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: Age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.
教育差距的扩大以及女性在死亡率方面优势的缩小在很大程度上源于吸烟方面的差异。不同队列和国家间吸烟与死亡率差异的变化，既有香烟使用的流行模式可以解释，也与生命历程的变化有关。为了更好地描述和理解生命历程中不断变化的差异，我们使用2010年法国健康晴雨表（N = 20,940）和2010年美国国家健康访谈调查样本成人档案（N = 20,444）中的吸烟史数据，比较了三个队列以及两个国家（法国和美国）的吸烟年龄模式。结果表明，从青春期到成年早期和中期，性别和教育差异在统计学上有显著扩大，从而加剧了青春期就已出现的差异。此外，生命历程中不断扩大的差异在不同队列中也有所变化：教育差异的年龄差距在最近的队列中有所增加（尤其是在法国），而性别差异的年龄差距则有所缩小。这些发现凸显了高收入国家吸烟与健康方面不平等的多种来源。
