Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications
Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications
复制标题
DOI：
10.1177/0022146510383498
复制
发表时间：
2010-11-01
影响因子：
5
通讯作者：
Tehranifar, Parisa
中科院分区：
文献类型：
--
作者：
Phelan, Jo C.;Link, Bruce G.;Tehranifar, Parisa
Link和Phelan（1995）发展了基本原因理论，以解释为什么社会经济地位（SES）和死亡率之间的关联一直存在，尽管疾病和风险因素发生了根本性的变化，被认为可以解释这一关联。他们提出，这种持久关联的结果是因为社会经济地位体现了一系列资源，如金钱、知识、声望、权力和有益的社会关系，这些资源在任何给定的时间都能保护健康，而不管什么机制是相关的。在本文中，我们阐述了该理论，回顾了主要发现，讨论了该理论的改进和限制，并讨论了可能减少健康不平等的卫生政策的影响。我们提倡鼓励医疗和其他促进健康的进步，同时打破或削弱这些进步与社会经济资源之间的联系的政策。这可以通过缩小社会经济资源本身的差距或制定干预措施来实现，这些干预措施就其性质而言，在社会经济地位群体中分配得更均匀。
Link and Phelan (1995) developed the theory of fundamental causes to explain why the association between socioeconomic status (SES) and mortality has persisted despite radical changes in the diseases and risk factors that are presumed to explain it. They proposed that the enduring association results because SES embodies an array of resources, such as money, knowledge, prestige, power, and beneficial social connections that protect health no matter what mechanisms are relevant at any given time. In this article, we explicate the theory, review key findings, discuss refinements and limits to the theory, and discuss implications for health policies that might reduce health inequalities. We advocate policies that encourage medical and other health-promoting advances while at the same time breaking or weakening the link between these advances and socioeconomic resources. This can be accomplished either by reducing disparities in socioeconomic resources themselves or by developing interventions that, by their nature, are more equally distributed across SES groups.