Educational Disparities in Adult Health: U.S. States as Institutional Actors on the Association.
Educational Disparities in Adult Health: U.S. States as Institutional Actors on the Association.
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DOI：
10.1177/2378023119835345
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发表时间：
2019-01-01
期刊：
影响因子：
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通讯作者：
Zajacova, Anna
中科院分区：
文献类型：
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作者：
Karas Montez, Jennifer;Hayward, Mark D;Zajacova, Anna
尽管有许多关于美国成人健康教育差异的研究，但对这种差异及其随时间增长的解释仍然不完整。我们认为，这种知识差距在一定程度上反映了个人主义的范式在美国的教育差异的健康研究。这些研究主要集中在最近的解释（例如，个体行为）而忽略上下文解释（例如，经济政策）。我们利用健康差距的背景理论来说明美国各州作为机构参与者如何塑造健康教育的重要性。使用两个具有全国代表性的数据集和7个45-89岁成年人的健康指标，我们发现，健康教育梯度的大小在各州之间存在显着差异。由于受教育程度较低的成年人的健康状况不同，其规模也不同。我们用州对香烟征收的消费税来说明州在健康方面形成教育差距的一种方式。我们的研究结果强调了将这些差异置于背景中的必要性。
Despite numerous studies on educational disparities in U.S. adult health, explanations for the disparities and their growth over time remain incomplete. We argue that this knowledge gap partly reflects an individualist paradigm in U.S. studies of educational disparities in health. These studies have largely focused on proximal explanations (e.g., individual behaviors) to the neglect of contextual explanations (e.g., economic policies). We draw on contextual theories of health disparities to illustrate how U.S. states, as institutional actors, shape the importance of education for health. Using two nationally-representative datasets and seven health measures for adults aged 45-89, we show that the size of the educational gradient in health varies markedly across states. The size varies because of variation in the health of lower-educated adults. We use state excise taxes on cigarettes to illustrate one way that states shape educational disparities in health. Our findings underscore the necessity of contextualizing these disparities.