To what extent do biomarkers account for the large social disparities in health in Moscow?
To what extent do biomarkers account for the large social disparities in health in Moscow?
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DOI：
10.1016/j.socscimed.2012.11.022
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发表时间：
2013-01-01
影响因子：
5.4
通讯作者：
Weinstein, Maxine
中科院分区：
文献类型：
--
作者：
Glei, Dana A.;Goldman, Noreen;Weinstein, Maxine
俄罗斯人口继续面临政治和经济挑战，几十年来普遍健康状况不佳，死亡率高，健康差距不断扩大。因此，俄罗斯人口健康与社会经济地位之间联系的生理因素是一个重要的研究课题。我们使用了2006年12月至2009年6月对莫斯科55岁及以上居民（n = 1495）进行的基于人口的调查数据，以解决两个问题。首先，在不同的生物标志物集群中，社会差异是否明显？第二，生物风险是否介导了社会经济地位和健康之间的联系？健康结果包括一般健康、身体功能和身体疼痛的分量表。社会经济地位由教育和物质资源指数来代表。通过20种生物标志物（包括心血管、炎症和神经内分泌标志物）以及24小时心电图监测的心率参数来测量生物风险。对于两种性别，标准心血管风险因素的年龄校正教育差异是显著的（男性：标准化β =-0.16，95%CI = -0.23 to -0.09;女性：β =-0.25，CI = -032 to -0.18）。炎症的教育差异在男性（β =-0.17，CI = -0.25至-0.09）和女性（β =-0.09，CI = -0.17至-0.01）中也很明显。仅男性受教育程度不同，心率参数不同（β =-0.10，CI = -0.18至-0.02）。物质资源和生物风险评分之间的关联一般弱于教育。就中介效应而言，生物风险对一般健康和身体功能的教育差距（19-36%）比对身体疼痛（12-18%）的影响更大。包括炎症标志物和心率参数这是健康结果的重要预测因子可以解释为什么我们比以前的研究解释了更多的社会差异。(C)2012爱思唯尔有限公司保留所有权利。
The Russian population continues to face political and economic challenges, has experienced poor general health and high mortality for decades, and has exhibited widening health disparities. The physiological factors underlying links between health and socioeconomic position in the Russian population are therefore an important topic to investigate. We used data from a population-based survey of Moscow residents aged 55 and older (n = 1495), fielded between December 2006 and June 2009, to address two questions. First, are social disparities evident across different clusters of biomarkers? Second, does biological risk mediate the link between socioeconomic status and health?Health outcomes included subscales for general health, physical function, and bodily pain. Socioeconomic status was represented by education and an index of material resources. Biological risk was measured by 20 biomarkers including cardiovascular, inflammatory, and neuroendocrine markers as well as heart rate parameters from 24-h ECG monitoring.For both sexes, the age-adjusted educational disparity in standard cardiovascular risk factors was substantial (men: standardized beta = -0.16, 95% CI = -0.23 to -0.09; women:, beta = -0.25, CI = -032 to -0.18). Education differences in inflammation were also evident in both men (beta = -0.17, CI = -0.25 to -0.09) and women (beta = -0.09, CI = -0.17 to -0.01). Heart rate parameters differed by education only in men (beta = -0.10, CI = -0.18 to -0.02). The associations between material resources and biological risk scores were generally weaker than those for education. Social disparities in neuroendocrine markers were negligible for men and women.In terms of mediating effects, biological risk accounted for more of the education gap in general health and physical function (19-36%) than in bodily pain (12-18%). Inclusion of inflammatory markers and heart rate parameters-which were important predictors of health outcomes-may explain how we accounted for more of the social disparities than previous studies. (C) 2012 Elsevier Ltd. All rights reserved.