Marmot M G, Fuhrer R, Ettner S L, Marks N F, Bumpass L L, Ryff C D
Department of Epidemiology and Public Health, University College London Medical School, England.
Milbank Q. 1998;76(3):403-48, 305. doi: 10.1111/1468-0009.00097.
The National Survey of Mid-life Developments in the United States (MIDUS) is one of several studies that demonstrate socioeconomic gradients in mortality during midlife. When MIDUS findings on self-reported health, waist to hip ratio, and psychological well-being were analyzed for their possible roles in generating socioeconomic differences in health, they revealed clear educational gradients for women and men (i.e., higher education predicted better health). Certain potential mediating variables, like household income, parents' education, smoking behavior, and social relations contributed to an explanation of the socioeconomic gradient. In addition, two census-based measures, combined into an area poverty index, independently predicted ill health. The results suggest that a set of both early and current life circumstances cumulatively contribute toward explaining why people of lower socioeconomic status have worse health and lower psychological well-being.
美国中年发展全国调查(MIDUS)是多项表明中年时期死亡率存在社会经济梯度的研究之一。当分析MIDUS关于自我报告健康状况、腰臀比和心理健康的研究结果在产生健康方面的社会经济差异中可能发挥的作用时,研究发现男性和女性都存在明显的教育梯度(即高等教育预示着更好的健康状况)。某些潜在的中介变量,如家庭收入、父母教育程度、吸烟行为和社会关系,有助于解释社会经济梯度。此外,两项基于人口普查的指标合并成一个地区贫困指数,可独立预测健康不佳。研究结果表明,一系列早期和当前的生活状况共同作用,有助于解释为什么社会经济地位较低的人群健康状况较差且心理健康水平较低。