Socioeconomic status and the health of youth: a multilevel, multidomain approach to conceptualizing pathways.
Socioeconomic status and the health of youth: a multilevel, multidomain approach to conceptualizing pathways.
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DOI：
10.1037/a0029416
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发表时间：
2013-05
影响因子：
22.4
通讯作者：
Chen, Edith
中科院分区：
文献类型：
--
作者：
Schreier, Hannah M. C.;Chen, Edith
以前的研究已经清楚地确定了低社会经济地位(SES)和不良的青年身体健康结果之间的联系。本文概述了低社会经济地位环境影响青少年健康的主要途径。我们关注当今年轻人中最普遍的两个慢性健康问题，哮喘和肥胖。我们回顾并提出了一个模型，该模型包含(1)多个层面的影响，包括邻居、家庭和个人层面，(2)环境中的社会和物理领域，以及(3)这些因素之间的动态关系。综合现有研究和我们提出的模型，人们注意到青年邻里环境中不良的身体和社会暴露会改变家庭特征和青年的心理社会和行为特征，从而增加青年出现健康问题的风险。我们还注意到，必须承认各种层面和领域的相互影响(例如，家庭和儿童之间)，这些影响形成了自我延续的影响模式，进一步突出了这些因素对青年健康的影响。最后，我们记录了不同水平的因素可以相互作用(例如，环境污染水平与儿童压力)，从而对青年健康产生独特的、协同的影响。我们的模式强调，评估对青年身体健康的影响不是孤立的，而是在青年生活的更广泛的社会和物质环境的背景下进行的。了解将低社会经济地位与青年长期健康轨迹联系起来的各种因素之间的复杂关系，对于制定和实施成功的干预措施和政策，最终减少健康差距是必要的。
Previous research has clearly established associations between low socioeconomic status (SES) and poor youth physical health outcomes. This article provides an overview of the main pathways through which low SES environments come to influence youth health. We focus on two of the most prevalent chronic health problems in youth today, asthma and obesity. We review and propose a model that encompasses (1) multiple levels of influence, including the neighborhood, family and person level, (2) both social and physical domains in the environment, and finally (3) dynamic relationships between these factors. A synthesis of existing research and our proposed model draw attention to the notion of adverse physical and social exposures in youth’s neighborhood environments altering family characteristics and youth psychosocial and behavioral profiles, thereby increasing youth’s risk for health problems. We also note the importance of acknowledging reciprocal influences across levels and domains (e.g., between family and child) that create self-perpetuating patterns of influence that further accentuate the impact of these factors on youth health. Finally, we document that factors across levels can interact (e.g., environmental pollution levels with child stress) to create unique, synergistic effects on youth health. Our model stresses the importance of evaluating influences on youth’s physical health not in isolation but in the context of the broader social and physical environments in which youth live. Understanding the complex relationships between the factors that link low SES to youth’s long-term health trajectories is necessary for the creation and implementation of successful interventions and policies to ultimately reduce health disparities.
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