Institute of Sociology and Social Work, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania.
Cent Eur J Public Health. 2020 Dec;28(4):251-259. doi: 10.21101/cejph.a6112.
This paper explores education-, income- and occupational class-related inequalities in risky health behaviours including into models all three factors together as well as their interactions, which has not been undertaken by previous studies analysing socioeconomic status (SES) related differences in risky health behaviours.
Our data source is the special module "Social Inequalities in Health" included into the European Social Survey Round 7 (ESS R7) and conducted in 20 European countries. We run nine separate multilevel binomial logistic regression analyses for all the risky health behaviours with all our independent and control variables including country as the second level random intercept. Into all the models we also included interaction terms to consider possible moderating effects of separate independent variables.
Education and income emerged as factors most consistently related to risky health behaviours, but occupational class differences were also found to be significant: eating vegetables or salad less than once a day and being daily smoker is positively related to lower SES as measured by all three indicators; eating fruits less than once a day is related to lower income and occupational class, while drinking alcohol at least several times a week is positively related to higher education and higher income; being physically active for less than 3 days per week is positively related to lower education; patterns of heavy smoking and binge drinking are inconsistently related to SES variables. We also found considerable regional variation, especially in fruit and vegetable consumption, being physically active and alcohol consumption patterns.
Without careful theoretical consideration linking SES and risky health behaviours, education, income and occupational class cannot substitute each other in the study of SES-related differences of health behaviours, as assumed in the larger part of research on the subject.
本文探讨了与教育、收入和职业阶层相关的风险行为不平等,包括将所有三个因素及其相互作用纳入模型,而以前分析社会经济地位(SES)与风险行为相关差异的研究并未涉及到这些因素。
我们的数据来源是欧洲社会调查第七轮(ESS R7)中包含的特殊模块“健康中的社会不平等”,该调查在 20 个欧洲国家进行。我们对所有风险行为进行了九项单独的多层次二项逻辑回归分析,所有独立和控制变量都包括国家作为二级随机截距。在所有模型中,我们还包括了交互项,以考虑单独自变量可能的调节作用。
教育和收入是与风险行为最相关的因素,但职业阶层差异也被发现具有显著意义:每天食用蔬菜或沙拉少于一次以及每天吸烟与所有三个指标衡量的 SES 较低呈正相关;每天食用水果少于一次与收入和职业阶层较低有关,而每周至少饮酒几次与教育程度较高和收入较高呈正相关;每周体育活动少于 3 天与教育程度较低呈正相关;重度吸烟和狂饮模式与 SES 变量的关系不一致。我们还发现了相当大的地区差异,尤其是在水果和蔬菜消费、体育活动和饮酒模式方面。
如果不仔细从理论上考虑 SES 和风险行为之间的联系,那么在研究 SES 相关健康行为差异时,教育、收入和职业阶层不能相互替代,这在该主题的大部分研究中都是假设的。