Health selection in the Whitehall II study, UK
Health selection in the Whitehall II study, UK
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DOI：
10.1016/s0277-9536(02)00201-0
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发表时间：
2003-05-01
影响因子：
5.4
通讯作者：
Marmot, M
中科院分区：
文献类型：
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作者：
Chandola, T;Bartley, M;Marmot, M
关于健康选择假说在解释健康社会梯度方面的重要性，一直存在相当大的争论。虽然有研究认为，这可能不是健康社会梯度的重要解释，但以前的分析并没有同时估计健康对社会地位变化的相对影响以及社会地位对健康变化的相对影响（社会因果关系）。使用结构方程模型的交叉滞后纵向分析能够估计这些途径的相对大小，这将有助于确定健康选择假说相对于社会因果假说的相对重要性。白厅11号研究的数据来自四个阶段（最初包括10308名年龄在35-55岁之间的英国公务员），收集了10年的时间。没有证据表明心理（GHQ-30和SF36）或身体健康（SF-36）对就业等级的变化有影响。当经济剥夺被用来衡量社会地位时，心理健康对男性社会地位的变化有显著影响，尽管这种健康选择效应比社会地位变化对健康的影响小2.5倍以上。研究结果表明，白厅11号研究中健康社会梯度的发展可能不能主要用健康选择效应来解释。(C) 2002 Elsevier Science Ltd.版权所有。
There has been considerable debate mer the importance of the health selection hypothesis for explaining social gradients in health. Although studies have argued that it may not be an important explanation of social gradients in health, previous analyses have not estimated, simultaneously, the relative effect of health on changes in social position and of social position on changes in health (social causation). Cross-lagged longitudinal analyses using structural equation models enable the estimation of the relative size of these pathways which would be useful in determining the relative importance of the health selection hypothesis over the social causation hypothesis.Data from four phases of the Whitehall 11 study (initially consisting of 10.308 men and women aged 35-55 in the British civil service) were collected over a 10 year period. There was no evidence for an effect of mental (GHQ-30 and SF36) or physical health (SF-36) on changes in employment grade. When financial deprivation was used as a measure of social position, there was a significant effect of mental health on changes in social position among men although this health selection effect was over two and a half times smaller than the effect of social position oil changes in health. The results suggest that the development of social gradients in health in the Whitehall 11 study may not be primarily explained in terms of a health selection effect. (C) 2002 Elsevier Science Ltd. All rights reserved.