教育不平等与自评健康和社会关系——基于 2002-2016 年欧洲社会调查的分析。
Educational inequalities in self-rated health and social relationships - analyses based on the European Social Survey 2002-2016.
机构信息
Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
出版信息
Soc Sci Med. 2020 Dec;267:112379. doi: 10.1016/j.socscimed.2019.112379. Epub 2019 Jun 29.
BACKGROUND
While there is evidence for educational health inequalities in Europe, studies on time trends and on the explanatory contribution of social relations are less consistent. It has been shown that the use of welfare state typologies can be helpful to examine health inequalities in a comparative perspective. Against this background, analyses are focused on three research questions: (1) How did educational inequalities in self-rated health (SRH) develop between 2002 and 2016 in different European countries? (2) In how far can structural and functional aspects of social relations help to explain these inequalities? (3) Do these explanatory contributions vary between different types of welfare states?
METHODS
Data stem from the European Social Survey. Data from 20 countries across 8 waves (2002-2016) was included in the sample (allocated to 5 types of welfare states). Structural aspects of social relations were measured by living with a partner, frequency of social contacts and social participation. Availability of emotional support was used as functional dimension. Educational level was assessed based on the International Standard Classification of Education. SRH was measured in all waves on a five-point scale by one question: "How is your health in general? Would you say it is very good, good, fair, bad or very bad?"
RESULTS
Across all countries, educational inequalities were increasing between 2002 and 2016. Explanatory contribution of emotional support, living with a partner, and social contacts was small (5% or less across the eight waves). Social participation explained 11% of the educational inequalities in SRH in the European countries. There were small variations in the explanatory contribution of social participation between welfare states.
CONCLUSIONS
Promoting social participation, especially of people with low education is a possible intervention to reduce inequalities in SRH in Europe.
背景
尽管有证据表明欧洲存在教育健康不平等现象，但关于时间趋势和社会关系解释贡献的研究则不太一致。已经表明，使用福利国家类型学可以有助于从比较的角度研究健康不平等现象。在此背景下，分析集中在三个研究问题上：（1）2002 年至 2016 年期间，不同欧洲国家的自我评估健康（SRH）方面的教育不平等状况如何发展？（2）社会关系的结构和功能方面在多大程度上可以帮助解释这些不平等？（3）这些解释性贡献在不同类型的福利国家之间是否有所不同？
方法
数据来自欧洲社会调查。样本包括来自 20 个国家的 8 个波次（2002-2016 年）的数据（分配给 5 种福利国家类型）。社会关系的结构方面通过与伴侣一起生活、社交接触的频率和社会参与来衡量。情感支持的可用性被用作功能维度。教育程度是根据国际教育分类标准评估的。在所有波次中，使用一个问题衡量 SRH：“你的总体健康状况如何？你会说非常好、好、一般、差还是非常差？”
结果
在所有国家中，2002 年至 2016 年间，教育不平等现象一直在加剧。情感支持、与伴侣一起生活和社交接触的解释力很小（在 8 个波次中均小于 5%）。社会参与对欧洲国家 SRH 中的教育不平等现象的解释力为 11%。在福利国家之间，社会参与的解释力差异较小。
结论
促进社会参与，特别是促进低教育水平者的社会参与，是减少欧洲 SRH 不平等现象的一种可能干预措施。
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