Health disparities across the lifespan: Meaning, methods, and mechanisms
Health disparities across the lifespan: Meaning, methods, and mechanisms
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DOI：
10.1111/j.1749-6632.2009.05337.x
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发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
Stewart, Judith
中科院分区：
文献类型：
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作者：
Adler, Nancy E.;Stewart, Judith
在过去的二十年里，实证研究的指数增长已经引发了对健康差距的关注。在本文中，我们展示了几个时代的社会经济地位（SES）和健康的研究进展。第一个时代反映了贫穷与健康之间联系的一种隐含的门槛模式。第二个时代的证据表明，社会经济地位与健康之间存在分级关联，教育、收入、职业或财富的每一次改善都与更好的健康结果相关。从对关联的描述转向对路径的探索，第三个时代侧重于SES与健康之间的联系机制，而第四个时代则扩展了考虑多层次影响的机制，第五个时代则关注因素之间的相互作用，而不仅仅是它们作为中介的主要影响或贡献。早期的问题仍然是研究的活跃领域，而后来的时代增加了深度和复杂性。
Over the past two decades, exponential growth of empirical research has fueled markedly increased concern about health disparities. In this paper, we show the progression of research on socioeconomic status (SES) and health through several eras. The first era reflected an implicit threshold model of the association of poverty and health. The second era produced evidence for a graded association between SES and health where each improvement in education, income, occupation, or wealth is associated with better health outcomes. Moving from description of the association to exploration of pathways, the third era focused on mechanisms linking SES and health, whereas the fourth era expanded on mechanisms to consider multilevel influences, and a fifth era added a focus on interactions among factors, not just their main effects or contributions as mediators. Questions from earlier eras remain active areas of research, while later eras add depth and complexity.