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更新埃德文·查德威克(Edwin Chadwick)关于职业地理不平等的开创性工作。

Updating Edwin Chadwick's seminal work on geographical inequalities by occupation.

机构信息

Department of Geography & Planning, University of Liverpool, Liverpool, L69 7ZT, UK.

School of Geography and the Environment, University of Oxford, Oxford, OX1 2DL, UK.

出版信息

Soc Sci Med. 2018 Jan;197:59-62. doi: 10.1016/j.socscimed.2017.11.055. Epub 2017 Dec 1.

Abstract

To honour the 175 anniversary of Edwin Chadwick's seminal 'Report on the Sanitary Conditions of the Labouring Poor', we update Chadwick's famous analysis of geographical differences in occupational based inequalities. Much of the field of Health Geography owes both its direction of development and its initial impetus to his 1842 report. The report presented evidence for the importance of local context to health, with individuals of the lowest occupations in Rutland living longer than individuals of the highest occupations in Liverpool. Here we update the 1842 analysis using data from the Office of National Statistics on individual mortality records by occupation (2010-12) and population data from the 2011 Census. Sex-specific directly standardised premature (16-74) mortality rates were calculated for hierarchical occupational categories similar to Chadwick's categories, for the nearest equivalent areas to those used in Chadwick's report. Although there is no longer consistent evidence on individuals in the lowest occupational group having lower mortality rates than those in the highest group, there were clear social gradients in mortality within each area and the extent of these inequalities varied between areas. Individuals who live in Rutland had lower premature mortality rates across each occupational group compared to the other areas. Our results demonstrate that while life expectancy has nearly doubled since Chadwick's report, social and spatial inequalities in health have persisted. We suggest that Chadwick's legacy on the importance of locality continues.

摘要

为纪念 Edwin Chadwick 的开创性报告《劳动人民卫生状况报告》发表 175 周年,我们更新了 Chadwick 对基于职业的不平等现象的著名地理差异分析。卫生地理领域的大部分内容都得益于他在 1842 年的报告所指明的发展方向和最初的推动力。该报告提出了地方环境对健康的重要性的证据,即拉特兰(Rutland)最低职业的个体比利物浦(Liverpool)最高职业的个体寿命更长。在这里,我们使用 2010-12 年国家统计局(Office of National Statistics)关于职业别个人死亡率记录(2010-12)和 2011 年人口普查的人口数据,更新了 1842 年的分析。我们按照类似于 Chadwick 分类的分层职业类别,为 Chadwick 报告中使用的最接近的区域,计算了性别特异性直接标准化的早逝(16-74 岁)死亡率。尽管在职业最低组别中的个体死亡率比职业最高组别中的个体更低的证据不再一致,但在每个区域内都存在明显的社会梯度差异,而且这些不平等的程度在不同区域之间存在差异。与其他地区相比,居住在拉特兰的个体在每个职业群体中都具有较低的早逝死亡率。我们的结果表明,尽管自 Chadwick 的报告以来,预期寿命几乎翻了一番,但健康方面的社会和空间不平等仍然存在。我们认为,Chadwick 关于地方重要性的遗产仍然存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ab7/5777825/ce7dedc66987/gr1.jpg

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