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社会经济地位差异对东亚两国自评健康的影响:日本与韩国的比较研究。

Socioeconomic disparities in self-rated health in two East Asian countries: Comparative study between Japan and Korea.

机构信息

Department of Social and Behavioral Sciences, Harvard. T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, Massachusetts, USA.

Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul, 06709, South Korea.

出版信息

Soc Sci Med. 2020 May;253:112945. doi: 10.1016/j.socscimed.2020.112945. Epub 2020 Mar 20.

Abstract

Although Japan and South Korea share a number of commonalities, social security systems are very different. We opt to compare socioeconomic disparities in self-rated health between these two countries. The analytic sample included those aged 20 years and older from the nationally representative surveys in Japan (Comprehensive Survey of Living Conditions) and South Korea (Korean Community Health Survey). As socioeconomic status, we used income (quintiles of equivalized annual household income) and education (five categories). We measured socioeconomic inequalities using two indices; the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII), in each age group for each country. In Japan, we found relatively little evidence of socioeconomic inequalities in self-rated health over the life course, on either the absolute or relative scale. In Korea, the absolute inequality assessed by SII of self-rated poor health was higher in middle and old age groups compared to other age groups, while relative inequality measured by RII was significantly higher in younger ages. In Japan with more generous welfare system to the older generations, health inequality was relatively lower compared to Korea. The gaps in health status for Korean people suggest where social policy might direct their efforts in the future - (a) reducing inequalities in working-age people by addressing the gap between standard workers & non-standard workers; and (b) improving the financial conditions of older people by shoring up the social security system.

摘要

尽管日本和韩国有许多共同之处,但社会保障体系却大不相同。我们选择比较这两个国家在自我评估健康方面的社会经济差异。分析样本包括来自日本(综合生活状况调查)和韩国(韩国社区健康调查)的全国代表性调查中年龄在 20 岁及以上的人群。作为社会经济地位,我们使用收入(等价年收入的五分位数)和教育(五类)。我们使用两个指数;不平等斜率指数(SII)和相对不平等指数(RII),在每个国家的每个年龄组中衡量社会经济不平等。在日本,我们发现,无论是在绝对还是相对水平上,自我评估健康状况的社会经济不平等在整个生命周期中都相对较少。在韩国,以 SII 衡量的自我评估健康状况不良的绝对不平等在中年和老年群体中比其他年龄群体更高,而 RII 衡量的相对不平等在较年轻的年龄组中则显著更高。在日本,由于对老年人的福利制度更加慷慨,因此与韩国相比,健康不平等程度相对较低。韩国人民在健康状况方面的差距表明,社会政策未来可能会在哪些方面做出努力——(a)通过解决标准工人和非标准工人之间的差距,减少工作年龄段人群的不平等;(b)通过加强社会保障制度来改善老年人的财务状况。

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