Arber S
Department of Sociology, University of Surrey Guildford, England.
Int J Health Serv. 1996;26(3):445-81. doi: 10.2190/MHUJ-U7KB-3W18-QQGH.
An increasing proportion of the population is not currently employed; health inequalities research should include these people in analyses. Labor market position is the key determinant of health in Western societies; it is essential to clarify the independent effects of the three main components of labor market position: educational qualifications, occupational class, and employment status. These issues are addressed using national data from the British General Household Survey for 1991-1992 and two measures of ill-health: limiting long-standing illness and self-reported health. Occupational class is a stronger predictor than educational qualifications of measures of ill-health for men and long-term illness for women. When employment status is included in the models, the class gradient is weakened, suggesting that omitting the nonemployed from class analyses will produce a seeming weakening of class inequalities in health. The analyses show that class inequalities in health are somewhat greater for nonemployed than employed men, but weaker for nonemployed than employed women. In spite of older people having left the labor market many years earlier, class based on their previous occupation continues to have a major effect on their health. Class should be the primary variable in analyses of inequalities in health, and all groups of the nonemployed should be analyzed using their last main occupation.
目前未就业的人口比例在不断增加；健康不平等研究应将这些人纳入分析。在西方社会，劳动力市场地位是健康的关键决定因素；明确劳动力市场地位的三个主要组成部分（教育程度、职业阶层和就业状况）各自的独立影响至关重要。利用1991 - 1992年英国综合住户调查的全国数据以及两种健康不佳衡量指标（长期限制疾病和自我报告的健康状况）来探讨这些问题。职业阶层比教育程度更能预测男性的健康不佳状况以及女性的长期疾病。当就业状况纳入模型时，阶层梯度会变弱，这表明在阶层分析中忽略未就业者会使健康方面的阶层不平等看似减弱。分析表明，未就业男性的健康阶层不平等比就业男性略大，但未就业女性的健康阶层不平等比就业女性弱。尽管老年人多年前就已离开劳动力市场，但基于他们以前职业的阶层对其健康仍有重大影响。在健康不平等分析中，阶层应是主要变量，所有未就业群体都应根据其最后的主要职业进行分析。
