A comparison of health and socioeconomic gradients in health between the United States and Canada.
A comparison of health and socioeconomic gradients in health between the United States and Canada.
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DOI：
10.1016/j.socscimed.2022.115099
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发表时间：
2022-08
影响因子：
5.4
通讯作者：
Siddiqi, Arjumand
中科院分区：
文献类型：
--
作者：
Zajacova, Anna;Siddiqi, Arjumand
21世纪初的数据显示，与加拿大相比，美国的整体健康状况更差，社会经济(SES)健康不平等程度更大。然而，在这20年里，两国的社会政治背景、健康水平和社会经济状况-健康不平等都发生了变化。根据新的数据，我们更新了两国之间的健康水平和SES-健康梯度的比较。分析侧重于自我评估的健康，基于两组互补的数据来源：韧性和恢复(RR)数据，这是美国-加拿大于2020年收集的关于社会状况的协调调查(N=3743)；以及来自每个国家的两个主要的具有全国代表性的健康数据来源：国家健康访谈调查(NHIS，N=104,027)和加拿大社区健康调查(CCHS，N=97,605)，两者均于2017-2018年收集。健康水平和差距，扣除人口和社会经济协变量，使用改进的泊松模型进行相对比较；描述性指标和健康状况一般/较差的预测水平从绝对角度显示比较。这两个数据来源都显示，美国成年人的健康状况继续明显比加拿大人差；这种劣势可能是由于两个人口之间的SES差异所致。然而，这两个数据来源得出了关于SES-健康不平等的相互矛盾的结果：RR数据表明，两国在社会经济健康梯度方面没有差异，而NHIS/CCHS数据显示，美国的教育和收入梯度明显高于加拿大。加拿大成年人的健康状况继续好于他们的美国同龄人，但目前尚不清楚健康不平等是否也会继续缩小。我们讨论了相互矛盾的发现的潜在原因，并呼吁进行大规模的新的跨国数据收集，这将使学者和政策制定者能够更好地了解美国和加拿大的健康和福祉。
Data from the early 2000s indicated worse overall health and larger socioeconomic (SES) health inequalities in the U.S. than in Canada. Yet, sociopolitical contexts, health levels, and SES-health inequalities have changed in both countries during the intervening two decades. Drawing on new data, we update the comparison of health levels and SES-health gradients between the two countries. Analyses, focused on self-rated health, are based on two complementary sets of data sources: Resilience and Recovery (RR) data, a harmonized U.S.-Canada survey of social conditions collected in 2020 (N = 3743); and a pair of leading nationally representative health data sources from each country: the National Health Interview Surveys (NHIS, N = 104,027) and the Canadian Community Health Survey (CCHS, N = 97,605), both collected in 2017–2018. Health levels and disparities, net of demographic and socioeconomic covariates, were estimated using modified Poisson models for relative comparisons; descriptives and predicted levels of fair/poor health show the comparisons from absolute perspective. Both data sources show that U.S. adults continue to have significantly worse health than Canadians; the disadvantage may be due to SES differences between the two populations. However, the two data sources yield conflicting findings on SES-health inequalities: the RR data indicate no difference between the two countries in socioeconomic health gradients, while the NHIS/CCHS data show a significantly steeper gradient in the U.S. than in Canada for both education and income. Canadian adults continue to report better health than their U.S. peers, but it is unclear whether health inequalities remain smaller as well. We discuss potential reasons for the conflicting findings and call for a large new cross-national data collection, which will enable scholars and policymakers to better understand health and wellbeing in the U.S. and Canadian contexts.
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影响因子：
4.7
作者：
Santos-Lozada, Alexis R.
通讯作者：
Santos-Lozada, Alexis R.
影响因子：
5.4
作者：
Huguet, Nathalie;Kaplan, Mark S.;Feeny, David
通讯作者：
Feeny, David
影响因子：
5.4
作者：
Altman, Barbara M.;Gulley, Stephen P.
通讯作者：
Gulley, Stephen P.
影响因子：
2.5
作者：
Mukaka, Mavuto;White, Sarah A.;Faragher, E. Brian
通讯作者：
Faragher, E. Brian
DOI：
10.1073/pnas.2024777118
发表时间：
2021-03-16
影响因子：
11.1
作者：
Case A;Deaton A
通讯作者：
Deaton A