Lahelma E, Rahkonen O, Huuhka M
Department of Public Health, University of Helsinki, Finland.
Soc Sci Med. 1997 Mar;44(6):789-99. doi: 10.1016/s0277-9536(96)00186-4.
This paper analyses the social patterning and change of health status among the Finnish population from the mid-1980s until the mid-1990s. A broad structural transformation has been going on in Finland including demographic, social structural and, in the early 1990s, particularly sudden and deep labour market changes. We first examine the patterning of health status and its change among the Finnish adult population by age; secondly by regional structure; thirdly by socioeconomic status, that is educational level; and fourthly by employment status, that is between the employed and the unemployed. Analyses were made separately for men and women. The data derive from two pooled nationwide "Surveys on Living Conditions" which were conducted in 1986 (N = 12,057) and in 1994 (N = 8650). Health status was measured by limiting long-standing illness (LLI) and self-assessed health (SAH) as below good. The overall trend shows that health status has remained stable or improved slightly among the Finnish adult population from 1986 to 1994. Age differences show leveling off as particularly men above age 45 in 1994 reported better health status than eight years before; those below age 45 tend to report somewhat poorer health. Also regional differences have declined; health in the East/North regions is approaching the level of the rest of the country, except the Helsinki Metropolitan region. Educational differences in health status continue to be clear; however, for men, differences in LLI between the two lower educational groups have levelled off by 1994. Also for men, employment status differences in LLI have declined by 1994; no corresponding levelling off was apparent for women. The health status and its social patterning among the Finnish adult population have remained rather stable during the recession and related social structural changes in the early 1990s. Certain levelling off has taken place among men. As a result men's and women's health inequalities now resemble each other more than eight years before. Adverse health consequences of the recession are supposed to take a longer time to show up.
本文分析了20世纪80年代中期至90年代中期芬兰人口健康状况的社会模式及其变化。芬兰一直在进行广泛的结构转型，包括人口结构、社会结构方面的转型，以及在20世纪90年代初，劳动力市场发生的特别突然且深刻的变化。我们首先按年龄考察芬兰成年人口健康状况的模式及其变化；其次按地区结构考察；第三按社会经济地位，即教育水平考察；第四按就业状况，即在就业者和失业者之间考察。分析分别针对男性和女性进行。数据来自1986年（N = 12,057）和1994年（N = 8650）进行的两次全国性综合“生活条件调查”。健康状况通过长期慢性病（LLI）以及自我评估健康状况（SAH）（低于良好水平）来衡量。总体趋势表明，1986年至1994年期间，芬兰成年人口的健康状况保持稳定或略有改善。年龄差异呈现出趋同态势，特别是1994年45岁以上的男性报告的健康状况比八年前更好；45岁以下的人往往报告健康状况稍差。地区差异也有所减小；东部/北部地区的健康状况正在接近全国其他地区的水平，但赫尔辛基大都市区除外。健康状况的教育差异仍然明显；然而，到1994年，两个较低教育水平组的男性在长期慢性病方面的差异已趋同。同样，到1994年，男性在长期慢性病方面的就业状况差异也有所减小；女性则没有明显的相应趋同情况。在20世纪90年代初的经济衰退及相关社会结构变化期间，芬兰成年人口的健康状况及其社会模式保持相对稳定。男性中出现了一定程度的趋同。结果是，现在男性和女性的健康不平等状况与八年前相比更为相似。经济衰退对健康的不利影响预计需要更长时间才会显现出来。
