School of Economics, University of Northern British Columbia, British Columbia V2N 4Z9, Canada.
Department of Economics, Near East University, Nicosia, Northern Cyprus, via Mersin 10, Turkey.
Health Promot Int. 2023 Aug 1;38(4). doi: 10.1093/heapro/daad067.
This study seeks to identify the impact of social determinants and lifestyle factors on life expectancy and self-perceived health as two measures of objective and subjective health, respectively, using data from Canadian provinces during 2007-21. Through a simple conceptual model, it lays out the direct and indirect pathways through which social and lifestyle determinants affect health. The conceptual model guides the formulation of empirical models, which are used to estimate the effects of social and lifestyle factors on health. The study uses 'panel-corrected standard errors' estimation method to obtain reliable results. The findings confirm that social determinants contribute directly and indirectly (through lifestyle) to life expectancy. For self-perceived health, however, the contributions of both social and lifestyle determinants are only direct. The latter result may be explained by the immediacy of lifestyle and its impact on health in individuals' minds, a notion that is constantly reinforced by the mainstream discourse on health promotion. Our study indicates that lifestyle factors should be addressed within the context of broader social determinants. In other words, an individual agency should be understood within the larger enveloping social structure. The study recognizes redistributive measures aimed at reducing social gradients in health as effective health promotion policies.
本研究旨在利用 2007 年至 2021 年加拿大各省的数据，确定社会决定因素和生活方式因素对预期寿命和自我感知健康的影响，分别作为客观和主观健康的两个衡量标准。通过一个简单的概念模型，它展示了社会和生活方式决定因素影响健康的直接和间接途径。该概念模型指导了经验模型的制定，这些模型用于估计社会和生活方式因素对健康的影响。该研究使用“面板校正标准误差”估计方法来获得可靠的结果。研究结果证实，社会决定因素直接和间接（通过生活方式）对预期寿命产生影响。然而，对于自我感知健康，社会和生活方式决定因素的贡献只是直接的。这一结果可能是由于生活方式的即时性及其对个人心目中健康的影响，这种观念被健康促进的主流话语不断强化。我们的研究表明，应在更广泛的社会决定因素背景下解决生活方式因素。换句话说，应该在更大的社会结构范围内理解个人能动性。该研究认识到旨在减少健康方面社会梯度的再分配措施是有效的健康促进政策。
