Socioeconomic gradients in health in international and historical context
Socioeconomic gradients in health in international and historical context
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DOI：
10.1111/j.1749-6632.2009.05384.x
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发表时间：
2010-01-01
期刊：
影响因子：
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通讯作者：
Rehkopf, David H.
中科院分区：
文献类型：
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作者：
Dow, William H.;Rehkopf, David H.
本文将健康的社会经济梯度置于更广泛的国际和历史背景中。我们提出的数据支持这样的结论，即目前美国健康的社会经济梯度既不是不可避免的，也不是不可改变的。这些文献揭示了美国的时期，梯度小得多，并确定了许多其他国家的例子，其不同的社会政策选择似乎导致了上级健康水平和公平，即使较少的总资源。这篇文章还揭示了各种假设机制在推动美国人口健康模式重大转变方面的潜在重要性。虽然必须仔细审查促成健康模式的个别机制，但更全面地看待随着人口健康的重大变化而变化的一系列因素也很有启发性。在这篇文章中，我们关注的是20世纪80年代，在此期间，美国的预期寿命增长相对于其他发达国家明显放缓，美国的健康差距大幅增加。与加拿大的比较表明，探索广泛的社会政策差异，如美国较弱的社会安全网，可能是未来调查的一个有前途的领域。
This article places socioeconomic gradients in health into a broader international and historical context. The data we present supports the conclusion that current socioeconomic gradients in health within the United States are neither inevitable nor immutable. This literature reveals periods in the United States with substantially smaller gradients, and identifies many examples of other countries whose different social policy choices appear to have led to superior health levels and equity even with fewer aggregate resources. The article also sheds light on the potential importance of various hypothesized mechanisms in driving major shifts in U.S. population health patterns. While it is essential to carefully examine individual mechanisms contributing to health patterns, it is also illuminating to take a more holistic view of the set of factors changing in conjunction with major shifts in population health. In this article, we do so by focusing on the period of the 1980s, during which U.S. life expectancy gains slowed markedly relative to other developed countries, and U.S. health disparities substantially increased. A comparison with Canada suggests that exploring broad social policy differences, such as the weaker social safety net in the United States, may be a promising area for future investigation.