Fox A J, Goldblatt P O, Adelstein A M
J Epidemiol Community Health. 1982 Jun;36(2):69-79. doi: 10.1136/jech.36.2.69.
The Office of Population Censuses and Surveys Longitudinal Study provides reliable mortality data by a much wider range of characteristics than are available for other national sources. Although it is based on only a 1% sample of the population, it broadens the scope of mortality analysis and permits study of changes in relationships using different aspects of the time dimension. Data from this study have made us increasingly aware of the importance of selection to the interpretation and understanding of observed mortality differentials. Here we focus on that aspect of selection called "health-related mobility," which is associated with the relative health of people acquiring or losing individual characteristics. It is suggested that, for characteristics affected by health-related mobility, mortality differentials would narrow or widen with increased duration of follow-up. One of the basis of this argument the contribution of health-related mobility to mortality differentials by economic position and social class, to regional differentials, and to family and household differentials is investigated. Selection can thus be shown to operate when people change economic position, when they migrate, or when they change marital status. While the effects of these selection processes can be shown to contribute to social class gradients they do not explain regional differentials and contribute only to a limited degree to differentials by marital status. Differentials by household circumstances also reflect the product of selection processes.
人口普查与调查办公室纵向研究提供的可靠死亡率数据所依据的特征范围,比其他全国性数据源所涵盖的范围要广泛得多。尽管它仅基于1%的人口样本,但它拓宽了死亡率分析的范围,并允许利用时间维度的不同方面来研究关系的变化。这项研究的数据使我们越来越意识到选择对于解释和理解观察到的死亡率差异的重要性。在这里,我们关注选择的一个方面,即“与健康相关的流动性”,它与获得或失去个体特征的人的相对健康状况相关。有人认为,对于受与健康相关的流动性影响的特征,随着随访时间的延长,死亡率差异会缩小或扩大。本文研究了这一论点的依据之一,即与健康相关的流动性对按经济地位和社会阶层、地区差异以及家庭差异划分的死亡率差异的贡献。因此可以证明,当人们改变经济地位、迁移或改变婚姻状况时,选择就会起作用。虽然这些选择过程的影响可以证明会导致社会阶层梯度,但它们并不能解释地区差异,对婚姻状况差异的贡献也很有限。家庭情况差异也反映了选择过程的结果。