Ji Ying, Yun Qingping, Jiang Xuewen, Chang Chun
School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China.
BMC Public Health. 2020 Sep 14;20(1):1401. doi: 10.1186/s12889-020-09508-5.
Numerous studies have clarified that family socioeconomic status (SES) is positively associated with health. However, the mechanism of family SES on health needs to be further investigated from a social epidemiological perspective. This study aims to analyze the relationships among family SES, family social capital, and adult general health and tests whether gender-based differences exist in the relationship between family social capital and general health.
A cross-sectional survey was used to collect data from 4187 representative households in six Chinese provinces. Family SES was conceptualized based on household income, family education, and family occupational status. Family social capital was measured by using family cohesion and health-related family support. General health was assessed by using five general health perception items of the Health Survey Short Form. Structural equation modeling (SEM) was applied to examine the relationships among family SES, family social capital, and general health, and a linear regression model was used to test gender-based differences.
The SEM showed that the direct effects of family SES, family cohesion, and health-related family support on health were 0.08 (P < 0.001), 0.17 (P < 0.001), and 0.10 (P < 0.001), respectively. Family SES had indirect effect (β = 0.05, P < 0.01) on general health via health-related family support. The total effect of family social capital (β = 0.27, P < 0.001) on general health was greater than that of family SES (β = 0.13, P < 0.001). Besides, the regression showed that the effect of health-related family support on general health was greater for women (β = 0.13, P < 0.001) than men (β = 0.04, P > 0.05).
The results provide strong support for the positive association between family SES, family social capital, and adult health. Family intervention programs should focus on establishing a harmonious family relationship to mobilize family support, particularly for the families with low cohesion and low SES.
众多研究已阐明家庭社会经济地位(SES)与健康呈正相关。然而,家庭SES对健康的影响机制仍需从社会流行病学角度进一步探究。本研究旨在分析家庭SES、家庭社会资本与成年人总体健康之间的关系,并检验家庭社会资本与总体健康之间的关系是否存在基于性别的差异。
采用横断面调查从中国六个省份的4187个代表性家庭收集数据。家庭SES基于家庭收入、家庭教育和家庭职业地位进行概念化。家庭社会资本通过家庭凝聚力和与健康相关的家庭支持来衡量。总体健康通过健康调查简表中的五个总体健康感知项目进行评估。应用结构方程模型(SEM)来检验家庭SES、家庭社会资本与总体健康之间的关系,并使用线性回归模型来检验基于性别的差异。
SEM显示,家庭SES、家庭凝聚力和与健康相关的家庭支持对健康的直接效应分别为0.08(P < 0.001)、0.17(P < 0.001)和0.10(P < 0.001)。家庭SES通过与健康相关的家庭支持对总体健康有间接效应(β = 0.05,P < 0.01)。家庭社会资本对总体健康的总效应(β = 0.27,P < 0.001)大于家庭SES(β = 0.13,P < 0.001)。此外,回归分析表明,与健康相关的家庭支持对女性总体健康的影响(β = 0.13,P < 0.001)大于男性(β = 0.04,P > 0.05)。
研究结果为家庭SES、家庭社会资本与成年人健康之间的正相关提供了有力支持。家庭干预项目应注重建立和谐的家庭关系以调动家庭支持,特别是对于凝聚力低和SES低的家庭。