Wolfson M, Rowe G, Gentleman J F, Tomiak M
Program in Population Health, Canadian Institute for Advanced Research.
J Gerontol. 1993 Jul;48(4):S167-79. doi: 10.1093/geronj/48.4.s167.
There is widespread interest in disparities in health status across income groups and other classifications of socioeconomic status. In Canada, as in many other countries, there is considerable evidence showing such disparities. This study reports an analysis of male mortality at ages 65 to 74 in relation to socioeconomic characteristics, specifically employment and self-employment earnings histories during the 10 to 20 years prior to age 65, marital status, disability, and age at retirement. The analysis is based on administrative data from the Canada Pension Plan covering more than 500,000 individuals. Significant mortality gradients are found throughout the earnings spectrum. These gradients are also clearly evident in a multivariate context. The results illustrate the major potential of administrative data for research. Substantively, the results cast doubt on the primacy of causal explanations such as "reverse causality" and "health selection" and raise important questions regarding pension and health policy.
不同收入群体以及社会经济地位的其他分类之间的健康状况差异受到广泛关注。与许多其他国家一样，加拿大有大量证据表明存在此类差异。本研究报告了对65至74岁男性死亡率与社会经济特征之间关系的分析，具体包括65岁之前10至20年的就业和自营职业收入历史、婚姻状况、残疾情况以及退休年龄。该分析基于来自加拿大养老金计划的行政数据，涵盖了50多万个人。在整个收入范围内都发现了显著的死亡率梯度。这些梯度在多变量背景下也很明显。结果说明了行政数据在研究中的主要潜力。实质上，结果对诸如“反向因果关系”和“健康选择”等因果解释的首要性提出了质疑，并引发了有关养老金和健康政策方面的重要问题。
