The usefulness of area-based socioeconomic measures to monitor social inequalities in health in Southern Europe
The usefulness of area-based socioeconomic measures to monitor social inequalities in health in Southern Europe
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DOI：
10.1093/eurpub/cki069
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发表时间：
2006-02-01
影响因子：
4.4
通讯作者：
Pastor, V
中科院分区：
文献类型：
--
作者：
Domínguez-Berjón, F;Borrell, C;Pastor, V
背景资料：研究目的是调查健康结果与几个小区域的社会经济指标之间的关系，以及与个人社会经济指标之间的关系，以检查外部效度。方法：基于1992年巴塞罗那健康访谈调查分析的横断面设计。获得了巴塞罗那市（西班牙）非机构化人口居民的代表性分层样本。本研究涉及4171名14岁以上的受访者。我们研究了感知健康状况，慢性病的存在和吸烟作为健康结果。地区社会经济措施（1991年人口普查）是在人口普查区一级产生的，个人社会经济措施是通过调查获得的教育水平和社会阶层。结果如下：通过个人社会经济指标，我们观察到，教育水平或社会阶层越低，报告公平，差或非常差的感知健康状况和呈现一些慢性疾病的概率越高。在吸烟方面，男性中的趋势相似[社会等级IV-V相对于社会等级I-II的比值比（OR）= 1.5; 95%置信区间（CI）= 1.2-1.9]，而女性中的趋势相反（OR = 0.7; 95% CI = 0.5-0.9）。从这个意义上说，不同地区的社会经济指标也存在差异，但妇女吸烟情况除外，这些指标没有显示出社会经济水平的任何差异。结论：几个人口普查地区为基础的社会经济措施类似的影响，在健康方面的不平等已经观察到。一般而言，这些不平等与基于个人的措施所获得的不平等具有相同的意义。西班牙人口普查的小地区社会经济措施可以大大加强对健康方面社会不平等的分析，克服公共卫生登记册和医疗记录中缺乏社会经济数据的问题。
Background: The study objective was to investigate the association between health outcomes and several small-area-based socioeconomic measures and also with individual socioeconomic measures as a check on external validity. Methods: Cross-sectional design based on the analysis of the Barcelona Health Interview Survey of 1992. A representative stratified sample of the non-institutionalised population resident in Barcelona city (Spain) was obtained. The present study refers to the 4171 respondents aged over 14. We studied perceived health status, presence of chronic conditions and smoking as health outcomes. Area socioeconomic measures (1991 census) were generated at census tract level and individual socioeconomic measures were educational level and social class obtained through the survey. Results: With individual socioeconomic measures we observed that the lower the educational level or social class, the higher the probability of reporting a perceived health status of fair, poor or very poor and of presenting some chronic condition. With regard to smoking, among men this trend was similar [odds ratio (OR) = 1.5; 95% confidence interval (CI) = 1.2-1.9 in social classes IV-V with respect to social classes I-II], while among women it was reversed (OR = 0.7; 95% CI = 0.5-0.9). With the different area-based socioeconomic indicators differences were also observed in this sense, with the exception of smoking in women for which these indicators do not show any differences by socioeconomic level. Conclusions: With several census area-based socioeconomic measures similar effects on inequalities in health have been observed. In general, these inequalities were in the same sense as those obtained with individual-based measures. Small-area-based socioeconomic measures from the Spanish census could greatly enhance analysis of social inequalities in health, overcoming the absence of socioeconomic data in public health registries and in medical records.