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美国已婚人士的自评健康轨迹:20 年间差距是否持续存在?

Self-Rated Health Trajectories among Married Americans: Do Disparities Persist over 20 Years?

作者信息

Berdahl Terceira A, McQuillan Julia

机构信息

Division of Research and Modeling, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD 20852, USA.

University of Nebraska-Lincoln, 709 Oldfather Hall, Lincoln, NE 68588-0324, USA.

出版信息

J Aging Res. 2018 Jan 11;2018:1208598. doi: 10.1155/2018/1208598. eCollection 2018.

Abstract

The purpose of this study is to understand self-rated health (SRH) trajectories by social location (race/ethnicity by gender by social class) among married individuals in the United States. We estimate multilevel models of SRH using six observations from 1980 to 2000 from a nationally representative panel of married individuals initially aged 25-55 (Marital Instability Over the Life Course Study). Results indicate that gender, race/ethnicity, and social class are associated with initial SRH disparities. Women are less healthy than men; people of color are less healthy than whites; lower educated individuals are less healthy than higher educated individuals. Women's health declined slower than men's but did not differ by race/ethnicity or education. Results from complex intersectional models show that white men with any college had the highest initial SRH. Only women with any college had significantly slower declines in SRH compared to white men with any college. For married individuals of all ages, most initial SRH disparities persist over twenty years. Intersecting statuses show that education provides uneven health benefits across racial/ethnic and gender subgroups.

摘要

本研究的目的是了解美国已婚人士中按社会位置(按性别、社会阶层划分的种族/族裔)划分的自评健康(SRH)轨迹。我们使用来自一个具有全国代表性的已婚人士面板(《生命历程中的婚姻不稳定研究》)的1980年至2000年的六项观察数据,估计了SRH的多层次模型。结果表明,性别、种族/族裔和社会阶层与初始SRH差异相关。女性的健康状况不如男性;有色人种的健康状况不如白人;受教育程度较低的个体健康状况不如受教育程度较高的个体。女性健康状况的下降速度比男性慢,但在种族/族裔或教育程度方面没有差异。复杂交叉模型的结果表明,上过大学的白人男性初始SRH最高。与上过大学的白人男性相比,只有上过大学的女性SRH下降速度明显较慢。对于所有年龄段的已婚人士来说,大多数初始SRH差异在二十多年间持续存在。交叉状况表明,教育在不同种族/族裔和性别亚组中提供的健康益处并不均衡。

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