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解释两个国家的主观社会地位:教育、职业、收入和童年环境的相对重要性。

Explaining subjective social status in two countries: The relative importance of education, occupation, income and childhood circumstances.

作者信息

Lindberg Marie Hella, Chen Gang, Olsen Jan Abel, Abelsen Birgit

机构信息

Department of Community Medicine, Faculty of Health Sciences, UiT - the Arctic University of Norway, 9037, Tromsø, Norway.

Centre for Health Economics, Monash University, 15 Innovation Walk, Clayton, VIC, 3800, Australia.

出版信息

SSM Popul Health. 2021 Jul 3;15:100864. doi: 10.1016/j.ssmph.2021.100864. eCollection 2021 Sep.

Abstract

In the literature on social inequalities in health, subjective socioeconomic position (SEP) is increasingly applied as a determinant of health, motivated by the hypothesis that having a high subjective SEP is health-enhancing. However, the relative importance of determinants of subjective SEP is not well understood. Objective SEP indicators, such as education, occupation and income, are assumed to determine individuals' position in the status hierarchy. Furthermore, an extensive literature has shown that past childhood SEP affects adult health. Does it also affect subjective SEP? In this paper, we estimate the relative importance of i) the common objective SEP indicators (education, occupation and income) in explaining subjective SEP, and ii) childhood SEP (childhood financial circumstances and parents' education) in determining subjective SEP, after controlling for objective SEP. Given that the relative importance of these factors is expected to differ across institutional settings, we compare data from two countries: Australia and Norway. We use data from an online survey based on adult samples, with N ≈ 1400 from each country. Ordinary least squares regression is conducted to assess how objective and childhood SEP indicators predict subjective SEP. We use Shapley value decomposition to estimate the relative importance of these factors in explaining subjective SEP. Income was the strongest predictor of subjective SEP in Australia; in Norway, it was occupation. Of the childhood SEP variables, childhood financial circumstances were significantly associated with subjective SEP, even after controlling for objective SEP. This association was the strongest in the Norwegian sample. Only the mother's education had a significant impact on subjective SEP. Our findings highlight the need to understand the specific mechanisms between objective and subjective SEP as determinants of inequalities in health, and to assess the role of institutional factors in influencing these complex relationships.

摘要

在关于健康方面社会不平等的文献中,主观社会经济地位(SEP)越来越多地被用作健康的一个决定因素,其依据的假设是,较高的主观SEP对健康有促进作用。然而,主观SEP的决定因素的相对重要性尚未得到很好的理解。客观SEP指标,如教育、职业和收入,被认为决定了个人在地位等级中的位置。此外,大量文献表明,童年时期的SEP会影响成年后的健康。它也会影响主观SEP吗?在本文中,我们估计了以下两方面的相对重要性:一是常见的客观SEP指标(教育、职业和收入)在解释主观SEP方面的重要性;二是童年SEP(童年时期的经济状况和父母的教育程度)在控制客观SEP后对主观SEP的决定作用。鉴于这些因素的相对重要性预计会因制度背景的不同而有所差异,我们比较了两个国家的数据:澳大利亚和挪威。我们使用基于成年样本的在线调查数据,每个国家约有1400个样本。进行普通最小二乘法回归以评估客观和童年SEP指标如何预测主观SEP。我们使用夏普利值分解来估计这些因素在解释主观SEP方面的相对重要性。在澳大利亚,收入是主观SEP的最强预测因素;在挪威,则是职业。在童年SEP变量中,即使在控制了客观SEP之后,童年时期的经济状况仍与主观SEP显著相关。这种关联在挪威样本中最为强烈。只有母亲的教育程度对主观SEP有显著影响。我们的研究结果强调,需要了解客观和主观SEP作为健康不平等决定因素之间的具体机制,并评估制度因素在影响这些复杂关系中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b7f/8278415/f653bfb3c585/gr1a.jpg

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