HEALTH INEQUALITIES AMONG BRITISH CIVIL-SERVANTS - THE WHITEHALL-II STUDY
HEALTH INEQUALITIES AMONG BRITISH CIVIL-SERVANTS - THE WHITEHALL-II STUDY
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DOI：
10.1016/0140-6736(91)93068-k
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发表时间：
1991-06-08
期刊：
影响因子：
168.9
通讯作者：
FEENEY, A
中科院分区：
文献类型：
--
作者：
MARMOT, MG;SMITH, GD;FEENEY, A
白厅对英国公务员的研究始于1967年，研究显示，社会阶层（根据就业等级评估）与各种疾病的死亡率之间存在明显的负相关。在1985年和1988年之间，我们调查了发病率的社会梯度的程度和原因，在一个新的队列的10314名公务员（6900名男性，3414名女性）年龄在35-55（白厅11研究）。参与者被要求回答一个自我管理的问卷调查，并参加筛选examin.In 20年分离的两项研究有没有减少的社会阶层的发病率差异：我们发现，就业等级和心绞痛的患病率，心电图缺血的证据，和慢性支气管炎的症状之间呈负相关。工作地位越低，自觉健康状况越差。在健康风险行为（包括吸烟、饮食和锻炼）、经济状况、身高反映的早期生活环境的可能影响、工作中的社会环境方面，（如工作单调，控制力低，满意度低），社会支持等方面的问题，在全社会提倡健康行为;应更多地关注社会环境、工作设计和收入不平等的后果。
The Whitehall study of British civil servants begun in 1967, showed a steep inverse association between social class, as assessed by grade of employment, and mortality from a wide range of diseases. Between 1985 and 1988 we investigated the degree and causes of the social gradient in morbidity in a new cohort of 10 314 civil servants (6900 men, 3414 women) aged 35-55 (the Whitehall 11 study). Participants were asked to answer a self-administered questionnaire and attend a screening examination.In the 20 years separating the two studies there has been no diminution in social class difference in morbidity: we found an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis. Self-perceived health status and symptoms were worse in subjects in lower status jobs. There were clear employment-grade differences in health-risk behaviours including smoking, diet, and exercise, in economic circumstances, in possible effects of early-life environment as reflected by height, in social circumstances at work (eg, monotonous work characterised by low control and low satisfaction), and in social supports.Healthy behaviours should be encouraged across the whole of society; more attention should be paid to the social environments, job design, and the consequences of income inequality.