Socioeconomic position and self-rated health: The contribution of childhood socioeconomic circumstances, adult socioeconomic status, and material resources
Socioeconomic position and self-rated health: The contribution of childhood socioeconomic circumstances, adult socioeconomic status, and material resources
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DOI：
10.2105/ajph.2004.047969
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发表时间：
2005-08-01
影响因子：
12.7
通讯作者：
Lahelma, E
中科院分区：
文献类型：
--
作者：
Laaksonen, M;Rahkonen, O;Lahelma, E
目标。我们通过分析儿童社会经济状况、成人社会经济地位和当前物质资源的指标来检验自我评估健康中的社会经济不平等。我们收集了赫尔辛基市雇用的中年成年人的数据(n=8970；回复率67%)。采用序贯Logistic回归模型分析7项社会经济指标与健康自我评价的相关性。在对年龄进行调整后，每项社会经济指标与自我评估的健康呈负相关。儿童时期的经济困难，而不是父母的教育，与健康有关，独立于所有其他社会经济指标。在根据其他社会经济指标进行调整后，受访者本身的教育程度和职业阶层与健康的关联仍然存在。住房拥有率和经济困难是完全调整后与健康相关的物质指标，而不是家庭收入。自己的教育程度和职业阶层与健康有一致的关联，但在调整了其他社会经济指标后，与收入的关联消失了。父母教育对健康的影响通过被调查者自身的教育起到中介作用。儿童期和成年期的经济困难都与健康和传统的社会经济指标有明显的关联。
Objectives. We examined socioeconomic inequalities in self-rated health by analyzing indicators of childhood socioeconomic circumstances, adult socioeconomic position, and current material resources.Methods. We collected data on middle-aged adults employed by the City of Helsinki (n=8970; 67% response rate). Associations between 7 socioeconomic indicators and health self-ratings of less than "good" were examined with sequential logistic regression models.Results. After adjustment for age, each socioeconomic indicator was inversely associated with self-rated health. Childhood economic difficulties, but not parental education, were associated with health independently of all other socioeconomic indicators. The associations of respondents' own education and occupational class with health remained when adjusted for other socioeconomic indicators. Home ownership and economic difficulties, but not household income, were the material indicators associated with health after full adjustment.Conclusions. Own education and occupational class showed consistent associations with health, but the association with income disappeared after adjustment for other socioeconomic indicators. The effect of parental education on health was mediated by the respondent's own education. Both childhood and adulthood economic difficulties showed clear associations with health and with conventional socioeconomic indicators.