Does Self-Rated Health Mean the Same Thing Across Socioeconomic Groups? Evidence From Biomarker Data
Does Self-Rated Health Mean the Same Thing Across Socioeconomic Groups? Evidence From Biomarker Data
复制标题
DOI：
10.1016/j.annepidem.2010.06.007
复制
发表时间：
2010-10-01
影响因子：
5.6
通讯作者：
Zajacova, Anna
中科院分区：
文献类型：
--
作者：
Dowd, Jennifer Beam;Zajacova, Anna
目的：自评健康（SRH）被广泛用于研究社会经济地位（SES）的健康不平等，但人们担心，不同社会经济地位群体的SRH可能不以相同的方式对应客观健康。我们测试了具有相同SRH的人的生物学风险水平是否因SES而不同。方法：我们分析了美国全国代表性的13877名年龄在25至80岁之间的成年人样本。我们使用相互作用模型和按四个SRH水平分层的模型来测试教育是否改变SRH与14种生物标志物之间的关联，这些生物标志物代表了代谢、心血管、炎症和器官功能。分层模型中估计的教育系数表明，在给定的自评健康类别中，生物标志物水平是否随教育程度而变化。结果：在相同的自评健康类别中，发现受教育程度在生物风险方面存在显著差异，特别是在较高的SRH水平下。总的来说，受教育程度越高的受访者在相同的SRH水平下具有更健康的生物标志物水平。结论：结果表明，以生物危险因素衡量的自我报告健康与客观健康的关系因社会经济地位而异。在使用SRH比较SES群体之间的健康风险时，应谨慎行事。中华流行病学杂志2010；20:743-749。(C) 2010爱思唯尔公司版权所有。
PURPOSE: Self-rated health (SRH) is widely used to study health inequalities by socioeconomic status (SES), but concern has arisen that SRH may not correspond to objective health in the same way for different SES groups. We test whether levels of biological risk differ by SES for those with the same SRH.METHODS: We analyzed a U.S. nationally representative sample of 13,877 adults aged 25 to 80 years. We tested whether education modifies the association between SRH and 14 biomarkers representing metabolic, cardiovascular, inflammatory, and organ function using both interaction models and models stratified by four levels of SRH. Estimated education coefficients in the stratified models indicated whether biomarker levels varied by educational attainment within a given self-rated health category.RESULTS: Significant variation in biological risk by education within the same self-rated health category was found, especially at higher levels of SRH. In general, respondents with more education had healthier levels of biomarkers for the same level of SRH.CONCLUSIONS: The results suggest that the relation of self-reported health to objective health, as measured by biological risk factors, differs by socioeconomic status. Caution should be exercised when using SRH to compare health risks across SES groups. Ann Epidemiol 2010;20:743-749. (C) 2010 Elsevier Inc. All rights reserved.