Lynch J W, Kaplan G A, Salonen J T
Human Population Laboratory, Western Consortium for Public Health, Berkeley, CA 94704-1011, USA.
Soc Sci Med. 1997 Mar;44(6):809-19. doi: 10.1016/s0277-9536(96)00191-8.
Attempts to explain socioeconomic inequalities in health have often made reference to the observation that poor health behaviours and psychosocial characteristics cluster in low socioeconomic status (SES) groups. Causal interpretation of the association between SES, health behaviour, psychosocial orientations, and health inequalities has been hampered because these factors and SES have usually been measured at the same point in time. Data from the Kuopio Ischaemic Heart Disease Risk Factor Study were used to examine the associations between measures of SES reflecting different stages of the lifecourse, health behaviours, and psychosocial characteristics in adulthood in a population-based study of 2674 middle-aged Finnish men. Results show that many adult behaviours and psychosocial dispositions detrimental to health are consistently related to poor childhood conditions, low levels of education, and blue-collar employment. Poor adult health behaviours and psychosocial characteristics were more prevalent among men whose parents were poor. Increases in income inequality which place children into low SES conditions may well produce a negative behavioural and psychosocial health dividend to be reaped in the future. Understanding that adult health behaviour and psychosocial orientations are associated with socioeconomic conditions throughout the lifecourse implies that efforts to reduce socioeconomic inequalities in health must recognize that economic policy is public health policy.
解释健康方面的社会经济不平等现象的尝试，常常会提及这样一种观察结果：不良健康行为和心理社会特征在社会经济地位较低的群体中聚集。对社会经济地位、健康行为、心理社会取向和健康不平等之间关联的因果解释受到了阻碍，因为这些因素和社会经济地位通常是在同一时间点进行测量的。在一项针对2674名芬兰中年男性的基于人群的研究中，使用了库奥皮奥缺血性心脏病危险因素研究的数据，来检验反映生命历程不同阶段的社会经济地位指标、健康行为和成年期心理社会特征之间的关联。结果表明，许多对健康有害的成年行为和心理社会倾向与童年时期的恶劣条件、低教育水平和蓝领工作始终相关。父母贫困的男性中，不良的成年健康行为和心理社会特征更为普遍。收入不平等加剧会使儿童处于社会经济地位较低的状况，这很可能会在未来产生负面的行为和心理社会健康影响。认识到成年期健康行为和心理社会取向在整个生命历程中都与社会经济状况相关，这意味着减少健康方面社会经济不平等的努力必须认识到经济政策就是公共卫生政策。
