Explaining gender differences in ill-health in South Korea: The roles of socio-structural, psychosocial, and behavioral factors
Explaining gender differences in ill-health in South Korea: The roles of socio-structural, psychosocial, and behavioral factors
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DOI：
10.1016/j.socscimed.2008.05.034
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发表时间：
2008-09-01
影响因子：
5.4
通讯作者：
Cho, Sung-Il
中科院分区：
文献类型：
--
作者：
Chun, Heeran;Khang, Young-Ho;Cho, Sung-Il
这项研究探讨并解释了尽管韩国快速现代化，其社会结构仍然基于传统性别关系，但健康方面的性别差异。对 2001 年韩国国家健康和营养检查调查中年龄 25-64 岁的 2897 名男性和 3286 名女性的全国代表性样本进行了分析。健康指标包括自评健康和慢性病。根据逻辑回归得出的性别和比值比 (OR) 计算年龄调整患病率。通过将决定性变量（社会结构、社会心理和行为）纳入基本逻辑回归模型，OR 的百分比变化被用来估计两种发病率指标中性别差距的贡献。结果显示，在这两项指标中，女性健康状况不佳的比例都很高，这表明老年群体中的差距越来越大。特定群体年龄调整后的健康不良患病率与社会经济地位呈反比关系。在调整每个决定因素时，就业状况、教育和抑郁症对性别差距的影响最大。在调整所有建议的决定因素后，可以解释自评健康状况的 78% 和慢性疾病的 86% 的过度 OR。按年龄分层后，完整模型为女性患慢性病的比例提供了完整的解释，但就自我评估的健康状况而言，女性患病率在较年轻的年龄组中仍然很明显。社会结构因素在女性健康状况不佳的原因中发挥了至关重要的作用。这一结果呼吁人们更加关注韩国社会结构决定因素造成的基于性别的健康不平等。建议进行跨文化验证研究，以进一步讨论不同环境中性别关系变化与发病率性别健康差距之间的联系。 (C) 2008 Elsevier Ltd. 保留所有权利。
This study examines and explains the gender disparity in health despite rapid modernization in South Korea where the social structure is still based on traditional gender relations. A nationally representative sample of 2897 men and 3286 women aged 25-64 from the 2001 Korean National Health and Nutrition Examination Survey was analyzed. Health indicators included self rated health and chronic disease. Age-adjusted prevalence was computed according to a gender and odds ratios (OR) derived from logistic regression. Percentage changes in OR by inclusion of determinant variables (socio-structural, psychosocial, and behavioral) into the base logistic regression model were used to estimate the contributions to the gender gap in two morbidity measures. Results showed a substantial female excess in ill-health in both measures, revealing an increasing disparity in the older age group. Group-specific age-adjusted prevalence of ill-health showed an inverse relationship to socioeconomic position. When adjusting for each determinant, employment status, education, and depression contributed the greatest to the gender gap. After adjusting for all suggested determinants, 78% for self rated health and 86% for chronic disease in excess OR could be explained. After stratifying for age, the full model provided a complete explanation for the female excess in chronic illness, but for self rated health a female excess was still evident for the younger age group. Socio-structural factors played a crucial role in accounting for female excess in ill-health. This result calls for greater attention to gender-based health inequality stemming from socio-structural determinants in South Korea. Cross-cultural validation studies are suggested for further discussion of the link between changing gender relations and the gender health gap in morbidity in diverse settings. (C) 2008 Elsevier Ltd. All rights reserved.