Inequalities in health: definitions, concepts, and theories.
Inequalities in health: definitions, concepts, and theories.
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健康的不平等：定义，概念和理论。
DOI：
10.3402/gha.v8.27106
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发表时间：
2015
影响因子：
2.6
通讯作者：
Subramanian SV
中科院分区：
文献类型：
--
作者：
Arcaya MC;Arcaya AL;Subramanian SV
来自不同背景、社会群体和国家的个人享有不同的健康水平。本文定义和区分不可避免的健康不平等和不公正和可预防的健康不平等。我们描述了通常检查健康不平等的沿着维度，包括全球人口，国家或州之间，以及地理区域内，按种族/民族，性别，教育，种姓，收入，职业等社会相关分组。不同的理论试图解释健康的群体水平差异，包括心理社会，物质剥夺，健康行为，环境和选择的解释。相对与绝对的概念;剂量反应与阈值;组成与背景;地点与空间;健康的生命历程观点;健康的因果途径;条件健康影响;以及群体水平与个体差异对于理解健康不平等至关重要。最后，我们反思了哪些条件使健康不平等不公正，并考虑优先消除健康差距的政策与侧重于提高人口整体健康水平的政策的优点。
Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose–response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population.