Svalestuen Sigbjørn
Department of Social Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
SSM Popul Health. 2022 Nov 29;20:101302. doi: 10.1016/j.ssmph.2022.101302. eCollection 2022 Dec.
There now exists a rich body of literature on the relationship between income, income inequality, and health. The discussion about the impact of income and income inequality on health includes psychosocial mechanisms, such as long-term perceptions of inferiority and social positioning, material advantage from income, and the structural conditions that define what people can do with their material resources.
This study investigated the extent to which income's effects on health are mediated by psychosocial stress, and to what extent those effects are moderated by country-level income inequality and economic development.
Data were collected from The European Social Survey, round 7. Multilevel moderated mediation analysis was applied to estimate the extent of psychosocial stress mediation of the effects of income on self-rated health. Moderated parameters were estimated over country-level income inequality and economic development.
Significant full or partial meditation by psychosocial stress was found in all 20 countries studied. Effects moderated by income inequality and GDP per capita showed expected relationships but failed to reach conventional levels of statistical significance.
Individual-level income remains important for explaining the income-health gradient in self-rated health in Europe. The income-health relationship and the extent to which it is mediated by psychosocial stress varies among countries but is not significantly moderated by contextual income or income inequality. Policies should be aimed at allowing a greater proportion of people to live in material comfort and reduced sense of financial precarity, and protecting individuals from harmful consequences of low income.
目前已有大量关于收入、收入不平等与健康之间关系的文献。关于收入和收入不平等对健康的影响的讨论包括心理社会机制，如长期的自卑感和社会地位感、收入带来的物质优势，以及决定人们如何利用其物质资源的结构条件。
本研究调查了心理社会压力在多大程度上介导了收入对健康的影响，以及这些影响在多大程度上受到国家层面的收入不平等和经济发展的调节。
数据收集自欧洲社会调查第7轮。应用多层次调节中介分析来估计心理社会压力对收入对自评健康影响的中介程度。调节参数是根据国家层面的收入不平等和经济发展来估计的。
在所有20个研究国家中都发现了心理社会压力的显著完全或部分中介作用。由收入不平等和人均国内生产总值调节的影响显示出预期的关系，但未达到传统的统计显著性水平。
个人层面的收入对于解释欧洲自评健康中的收入-健康梯度仍然很重要。收入与健康的关系以及心理社会压力对其的中介程度在不同国家有所不同，但不受背景收入或收入不平等的显著调节。政策应旨在让更大比例的人生活在物质舒适且经济不稳定感较低的环境中，并保护个人免受低收入的有害影响。
