Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?
Social class and self-reported health status among men and women: what is the role of work organisation, household material standards and household labour?
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DOI：
10.1016/s0277-9536(03)00408-8
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发表时间：
2004-05-01
影响因子：
5.4
通讯作者：
Artazcoz, L
中科院分区：
文献类型：
--
作者：
Borrell, C;Muntaner, C;Artazcoz, L
社会阶层被理解为对生产性资产的所有权和控制权的社会关系，它利用了传统的社会分层衡量标准无法捕捉到的部分健康社会差异。本研究的目的是分析自我报告的健康状况与社会阶层之间的关联，并考察工作组织、物质标准和家庭劳动作为解释这种关联的潜在中介因素的作用。我们使用了巴塞罗那健康访谈调查，这是 2000 年对该市非机构人口中 10,000 名居民进行的横断面调查。这是一个分层样本，分层为该市的 10 个区。本研究针对 16-64 岁的工作人群（2345 名男性和 1874 名女性）进行。社会阶级地位是用埃里克·奥林·赖特的指标根据对生产性资产的所有权和控制权来衡量的。因变量是自我报告的健康状况。自变量是社会阶层、年龄、心理和身体工作条件、工作不安全感、劳动合同类型、每周工作时数、家里拥有电器以及家务劳动（每周工作时数、独自做家务以及家里有孩子、老人或残疾人）。通过添加不同的自变量块来执行几个层次逻辑回归模型。在男性中，小雇主和小资产阶级、主管、半熟练工人（调整后优势比-aOR：4.92；95% CI：1.88-12.88）和非熟练工人（aOR：7.69；95% CI：3.01-19.64）中健康状况不佳的患病率较高。除每周工作时数外，工作组织和家庭物质标准与不良健康状况有关。工作组织变量是健康方面社会阶层不平等的主要解释变量，尽管物质标准也有所贡献。在女性中，只有非技术工人的健康状况比经理和技术主管的参考类别更差（aOR：3.25；95％CI：1.37-7.74）。除每周工作时数外，工作组织和家庭物质标准的所有指标均达到统计显着性。与男性相比，女性每周家务劳动的小时数与健康状况不佳相关（aOR：1.02；95% CI：1.01-1.03）。在完整模型中显示出与男性不同的模式，家庭物质匮乏和每周家务劳动时间与女性健康状况不佳有关。我们的研究结果表明，在男性中，社会阶层地位与健康状况不佳之间的部分关联可以归因于心理和身体工作条件以及工作不安全感。在女性中，工人（非所有者、非管理人员和无资格）阶级职位与健康之间的关联在很大程度上是由工作条件、家庭物质条件和家务劳动量来解释的。 (C) 2003 Elsevier Ltd. 保留所有权利。
Social class understood as social relations of ownership and control over productive assets taps into parts of the social variation in health that are not captured by conventional measures of social stratification. The objectives of this study are to analyse the association between self-reported health status and social class and to examine the role of work organisation, material standards and household labour as potential mediating factors in explaining this association.We used the Barcelona Health Interview Survey, a cross-sectional survey of 10,000 residents of the city's non-institutionalised population in 2000. This was a stratified sample, strata being the 10 districts of the city. The present study was conducted on the working population, aged 16-64 years (2345 men and 1874 women). Social class position was measured with Erik Olin Wright's indicators according to ownership and control over productive assets. The dependent variable was self-reported health status. The independent variables were social class, age, psychosocial and physical working conditions, job insecurity, type of labour contract, number of hours worked per week, possession of appliances at home, as well as household labour (number of hours per week, doing the housework alone and having children, elderly or disabled at home). Several hierarchical logistic regression models were performed by adding different blocks of independent variables.Among men the prevalence of poor reported health was higher among small employers and petit bourgeois, supervisors, semi-skilled (adjusted odds ratio-aOR: 4.92; 95% CI: 1.88-12.88) and unskilled workers (aOR: 7.69; 95%CI: 3.01-19.64). Work organisation and household material standards were associated with poor health status with the exception of number of hours worked per week. Work organisation variables were the main explanatory variables of social class inequalities in health, although material standards also contributed. Among women, only unskilled workers had poorer health status than the referent category of manager and skilled supervisors (aOR: 3.25; 95%CI: 1.37-7.74). All indicators of work organisation and household material standards reached statistical significance, excepting the number of hours worked per week. In contrast to men, among women the number of hours per week of household labour was associated with poor health status (aOR: 1.02; 95% CI: 1.01-1.03). Showing a different pattern from men in the full model, household material deprivation and hours of household labour per week were associated with poor health status among women.Our findings suggest that among men, part of the association between social class positions and poor health can be accounted for psychosocial and physical working conditions and job insecurity. Among women, the association between the worker (non-owner, non-managerial, and un-credentiated) class positions and health is substantially explained by working conditions, material well being at home and amount of household labour. (C) 2003 Elsevier Ltd. All rights reserved.