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剖析三十年来塑造智利主观健康状况的人口和社会经济因素:对健康政策的启示

Unraveling the demographic and socioeconomic factors shaping subjective health status in Chile over three decades: implications for health policy.

作者信息

Baquedano-Rodríguez Marjorie, Rosas-Muñoz Juan, Ortega-Bastidas Javiera, Schilling-Norman Mary Jane, Pérez-Villalobos Cristhian

机构信息

Departamento de Economía y Finanzas, Universidad del Bío-Bío, Concepción, 4030000, Chile.

Interdisciplinary Center for Aquaculture Research (INCAR), Concepción, 4030000, Chile.

出版信息

BMC Public Health. 2025 Feb 20;25(1):694. doi: 10.1186/s12889-025-21720-9.

Abstract

BACKGROUND

Subjective health status (SHS) is a key indicator of population health and is influenced by various demographic and socioeconomic factors. However, there is a limited understanding of how these factors have shaped SHS in Chile over the past three decades and how health policies have addressed these determinants. This study aims to analyze the predictors of SHS at an individual level and evaluate the alignment of health-focused social programs with these predictors to promote equitable health outcomes in Chile.

METHOD

We utilized data from the World Values Survey (WVS) to examine the impact of demographic and socioeconomic factors on SHS in Chilean adults from 1990 to 2019, applying two probit regression models with and without time control. Additionally, we analyzed the scope of 479 health-focused social programs implemented by the Chilean Government between 2012 and 2021 to determine their contribution to improving SHS and other life domains such as work, education, and social protection.

RESULTS

Age, female, primary education, retirement, and lower-income quintiles are associated with lower SHS over time. Conversely, being a parent, having higher education, and having higher income quintiles relate to higher SHS. Education and income consistently shape SHS over time. Health-focused programs interact with other areas, providing social protection and education. Nevertheless, there are opportunities to positively affect other life domains under an intersectional social policy perspective.

CONCLUSIONS

The findings underscore the potential of well-informed health policies to substantially improve SHS. They suggest that a holistic approach, including environmental and social determinants, is crucial for advancing public health outcomes in Chile. We offer some recommendations for policy purposes.

摘要

背景

主观健康状况(SHS)是人口健康的关键指标,受到各种人口和社会经济因素的影响。然而,对于过去三十年来这些因素如何在智利塑造主观健康状况,以及卫生政策如何应对这些决定因素,人们的了解有限。本研究旨在分析个体层面主观健康状况的预测因素,并评估以健康为重点的社会项目与这些预测因素的契合度,以促进智利公平的健康结果。

方法

我们利用世界价值观调查(WVS)的数据,通过应用两个有时间控制和无时间控制的概率回归模型,研究1990年至2019年期间人口和社会经济因素对智利成年人主观健康状况的影响。此外,我们分析了智利政府在2012年至2021年期间实施的479个以健康为重点的社会项目的范围,以确定它们对改善主观健康状况以及工作、教育和社会保护等其他生活领域的贡献。

结果

随着时间的推移,年龄、女性、小学教育、退休以及较低收入五分位数与较低的主观健康状况相关。相反,为人父母、接受高等教育以及较高收入五分位数与较高的主观健康状况相关。随着时间的推移,教育和收入持续塑造主观健康状况。以健康为重点的项目与其他领域相互作用,提供社会保护和教育。然而,从交叉社会政策的角度来看,仍有机会对其他生活领域产生积极影响。

结论

研究结果强调了明智的卫生政策在大幅改善主观健康状况方面的潜力。它们表明,包括环境和社会决定因素在内的整体方法对于推进智利的公共卫生成果至关重要。我们为政策目的提供了一些建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d30/11840972/6be11a418d82/12889_2025_21720_Fig1_HTML.jpg

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