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如何解释社会经济地位与健康之间的梯度关系?来自工作场所新冠病毒感染的证据。

What explains the socioeconomic status-health gradient? Evidence from workplace COVID-19 infections.

作者信息

Godefroy Raphael, Lewis Joshua

机构信息

Department of Economics, Université de Montréal, 3150, Rue Jean-Brillant, Montreal, QC, H3T1N8, Canada.

出版信息

SSM Popul Health. 2022 Jun;18:101124. doi: 10.1016/j.ssmph.2022.101124. Epub 2022 May 30.

Abstract

This paper studies the contribution of the workplace to the SES-health gradient. Our analysis is based on a unique dataset that tracks various health outcomes and workplace risks among healthcare workers during the first four months of the coronavirus 2019 (COVID-19) pandemic. The setting provides an exceptional opportunity to test for work-related disparities in health, while controlling for confounding determinants of the SES-health gradient. We find that low-SES nurses were systematically more likely to contract COVID-19 as a result of workplace exposure. These differentials existed in all healthcare institutions, but were particularly large in non-hospital settings. In contrast, we find no relationship between SES and nonwork-related infection rates. The differences in workplace infection rates are substantially larger than those implied by standard 'task-based' indices of transmission risk, and cannot be attributable to easily identifiable metrics of workplace risk. Together, our results show how subtle differences in work conditions or job duties can substantially contribute to the SES-health gradient.

摘要

本文研究工作场所对社会经济地位(SES)与健康梯度的影响。我们的分析基于一个独特的数据集,该数据集跟踪了2019年冠状病毒病(COVID-19)大流行前四个月医护人员的各种健康结果和工作场所风险。这一背景为测试与工作相关的健康差异提供了绝佳机会,同时控制了SES与健康梯度的混杂决定因素。我们发现,低社会经济地位的护士因工作场所接触而感染COVID-19的可能性系统性地更高。这些差异在所有医疗机构中都存在,但在非医院环境中尤为显著。相比之下,我们发现社会经济地位与非工作相关感染率之间没有关系。工作场所感染率的差异远大于标准“基于任务”的传播风险指数所暗示的差异,且不能归因于易于识别的工作场所风险指标。总之,我们的结果表明工作条件或工作职责中的细微差异如何能极大地影响SES与健康梯度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb23/9150908/b102d6a87184/gr1_lrg.jpg

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