Social mobility and 21 year mortality in a cohort of Scottish men
Social mobility and 21 year mortality in a cohort of Scottish men
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DOI：
10.1016/s0277-9536(98)00061-6
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发表时间：
1998-10-01
影响因子：
5.4
通讯作者：
Blane, D
中科院分区：
文献类型：
--
作者：
Hart, CL;Smith, GD;Blane, D
这项前瞻性队列研究的目的是确定代内和代际之间社会阶层的变化对死亡风险和死亡率的社会经济差异的影响。苏格兰西部 27 个工作场所。 5567 名年龄在 35-64 岁之间的男性在筛查时提供了有关其父亲的职业、他们自己的第一份职业以及筛查时的职业的信息。 21 年后测量了代际和代内社会流动群体的广泛死亡原因的死亡风险。对于 3 种流动途径（童年到筛查、进入劳动力市场到筛查以及童年到进入劳动力市场）中的全部或部分，4 个组（稳定的非体力、向上流动、向下流动和稳定的体力）的舒张压、体重指数、当前吸烟、提前离校、心绞痛、支气管炎、严重胸痛以及生活在贫困地区的比例均出现增加。血清胆固醇、身高、FEV1、运动、从不吸烟者和戒烟者、饮酒者和汽车使用者的数值均出现下降。对于童年期与筛查之间以及童年期与进入劳动力市场之间的流动性而言，稳定的体力劳动组的死亡风险最高，而稳定的非体力劳动组的全因、心血管疾病和其他死因的死亡风险最低。向上和向下流动的群体具有中等风险。对于癌症死亡率，稳定手动组的风险最高，其他组的风险较低且相似。对于劳动力市场进入和筛查之间的流动性而言，全因死亡率和心血管死亡率风险最高的是向下流动群体。就癌症死亡率而言，在任何场合从事体力活动的男性的癌症死亡率都较高。对风险因素的调整有所减弱，但无法完全解释死亡风险的差异。总体而言，稳定的非体力劳动组和稳定的体力劳动组之间的死亡风险存在重大差异，而社会流动性对此没有贡献。除了少数代内向下流动的群体外，几乎没有证据表明社会流动性本身与死亡率结果相关，这与根据一生社会经济经验所预期的结果不同。这与社会经济地位对死亡风险的主要影响是累积性的建议是一致的。贯穿生命全过程的行动。 (C) 1998 Elsevier Science Ltd. 保留所有权利。
The objective of this prospective cohort study was to determine the contribution of changes in social class within and between generations to mortality risk and to socioeconomic differentials in mortality. In 27 workplaces in the west of Scotland. 5567 men aged 35-64 years when screened, provided information on their father's occupation, their own first occupation and their occupation at screening. Mortality risk, from broad causes of death by intergenerational and intragenerational social mobility groups, was measured after 21 years. For all or some of the 3 routes of mobility (childhood to screening, labour market entry to screening and childhood to labour market entry), increasing values were seen across the 4 groups (stable non manual, upwardly mobile, downwardly mobile and stable manual) for diastolic blood pressure, body mass index, current smoking, early school leaving, angina, bronchitis, severe chest pain, and proportion living in deprived areas. Decreasing values were seen for serum cholesterol, height, FEV1, exercise, never and ex-smokers: wine drinkers and car users. For mobility between childhood and screening and between childhood and labour market entry, mortality risk was highest for the stable manual group and lowest For the stable non manual group for all cause, cardiovascular disease and other causes of death. The upwardly and downwardly mobile groups had intermediate risks. For cancer mortality, the stable manual group had the highest risk with the other groups having lower and similar risks. For mobility between labour market entry and screening, the highest risk was for the downwardly mobile group for all cause and cardiovascular mortality. For cancer mortality, the risk was higher for men in manual social classes at all occasions. Adjustment for risk factors attenuated but could not completely explain the differentials in mortality risk. Overall, major differences in mortality risk were seen between the stable non manual and the stable manual groups, to which social mobility does not contribute. With the exception of the small intragenerationally downwardly mobile group there was little evidence that social mobility itself was associated with mortality outcomes different from those expected on the basis of lifetime socioeconomic experience. This is consistent with the suggestion that the main influence of socioeconomic position on mortality risk is an accumulative one. acting across the lifecourse. (C) 1998 Elsevier Science Ltd. All rights reserved.