Kuate Defo B
Département de Démographie, Universite de Montréal, Québec, Canada.
Soc Sci Med. 1997 Apr;44(7):1023-42. doi: 10.1016/s0277-9536(96)00228-6.
Research on the effects of socioeconomic disadvantage and women's status on women's health is important for policy makers in developing countries, where limited resources make it crucial to use existing maternal and child health care resources to the best advantage. Using a community-based data set collected prospectively in Cameroon, this study attempts to understand the extent to which socioeconomic factors and women's status have influences on women's health. The most important finding is that the burden of illness rests disproportionately on the economically disadvantaged women and on those with low social status. The long-term effects of social disadvantage are apparent in the excesses of morbidity among women who are not employed at the time of their children's birth, women living in poor neighborhoods, and those living in households without modern amenities. The maternal morbidity patterns during the postpartum period indicate that the women's reports of their recovery and health status from childbirth extend far beyond the first few weeks that previous studies have focused on. From a theoretical perspective, this study has demonstrated the importance of the "intermediate" framework for the study of women's health: the operations of effects of a number of background characteristics are mediated by more proximate determinants of women's health. These results remain robust even after controlling for other measured factors and after correcting for unmeasured heterogeneity and sample selection; this helps to dismiss the potential influence of some artifacts. While this study suggests that there are opportunities within the existing health care system for meeting many of the health care needs of the socially disadvantaged, further biobehavioral and psychosocial research is needed to determine how women's status and social disadvantage influence the demand for health care services, in order to ensure equitable as well as a more effective delivery of health care services and to break the vicious circle of disadvantage.
对于发展中国家的政策制定者而言，研究社会经济劣势和女性地位对女性健康的影响至关重要，因为在这些国家，资源有限，因此将现有的母婴保健资源发挥出最大优势至关重要。本研究利用在喀麦隆前瞻性收集的基于社区的数据集，试图了解社会经济因素和女性地位对女性健康的影响程度。最重要的发现是，疾病负担过多地落在经济上处于劣势的女性以及社会地位较低的女性身上。社会劣势的长期影响在孩子出生时未就业的女性、居住在贫困社区的女性以及生活在没有现代便利设施家庭中的女性的高发病率中显而易见。产后时期的孕产妇发病模式表明，女性对分娩后恢复情况和健康状况的报告远远超出了以往研究所关注的最初几周。从理论角度来看，本研究证明了 “中间” 框架对女性健康研究的重要性：许多背景特征的影响作用是由更直接的女性健康决定因素介导的。即使在控制了其他测量因素并校正了未测量的异质性和样本选择之后，这些结果仍然稳健；这有助于消除一些人为因素的潜在影响。虽然本研究表明，在现有的医疗保健系统内存在满足社会弱势群体许多医疗保健需求的机会，但仍需要进一步开展生物行为和社会心理研究，以确定女性地位和社会劣势如何影响对医疗保健服务的需求，从而确保公平且更有效地提供医疗保健服务，并打破劣势的恶性循环。
