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从流行病学角度解释死亡率的社会差异:白厅研究

Epidemiological approach to the explanation of social differentiation in mortality: the Whitehall studies.

作者信息

Marmot M

机构信息

University College Medical School London.

出版信息

Soz Praventivmed. 1993;38(5):271-9. doi: 10.1007/BF01359588.

Abstract

A consistent feature of mortality statistics in England and Wales are the social class differences which have even widened in the decade from 1971 to 1981. Two large studies of British Civil Servants, the Whitehall and Whitehall II studies, add to the understanding of social class differences in mortality and morbidity. Some of their results are presented to illustrate current concepts of social class differences in health. There is no evidence for an effect of health selection. The magnitude of social class differences vary for different causes of death, presumably as a sign of the effect of specific factors for specific disease. The observation that social class differences apply to most causes of death, however, suggest that factors like early life experience, difference in behaviour, material and psychosocial conditions act in an unspecific way.

摘要

英格兰和威尔士死亡率统计数据的一个一贯特征是社会阶层差异,这种差异在1971年至1981年的十年间甚至有所扩大。两项针对英国公务员的大型研究,即白厅研究和白厅二期研究,增进了人们对死亡率和发病率方面社会阶层差异的理解。现展示其中一些研究结果,以阐明当前关于健康方面社会阶层差异的概念。没有证据表明存在健康选择效应。社会阶层差异的幅度因不同死因而异,这大概表明特定疾病的特定因素所产生的影响。然而,社会阶层差异适用于大多数死因这一观察结果表明,诸如早年经历、行为差异、物质及心理社会状况等因素以一种非特定的方式发挥作用。

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