SOCIOECONOMIC INEQUALITIES IN HEALTH - NO EASY SOLUTION
SOCIOECONOMIC INEQUALITIES IN HEALTH - NO EASY SOLUTION
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DOI：
10.1001/jama.269.24.3140
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发表时间：
1993-06-23
影响因子：
120.7
通讯作者：
SYME, SL
中科院分区：
文献类型：
--
作者：
ADLER, NE;BOYCE, WT;SYME, SL
目标。-社会经济地位（SES）与疾病和死亡风险密切相关。全民健康保险是解决这种健康不平等的一种补救办法。这篇文章认为通过SES影响健康的机制，并认为需要一个更广泛和更全面的方法。使用MEDLINE和综述文章和参考文献调查发表的文章。方法和结果。在不同的国家，包括那些全民健康保险的社会经济地位与健康结果的关联研究进行了审查。社会经济地位与社会经济地位等级中所有级别的健康状况有关，而获得保健的机会在这种关联中几乎没有占到任何比例。其他机制的建议和政策和临床实践的影响进行了讨论。单靠医疗保险不可能显著减少社会经济地位在健康方面的差异。在政策决定和临床实践中应注意其他可能影响健康和疾病模式的SES相关因素。
Objective.-Socioeconomic status (SES) is strongly associated with risk of disease and mortality. Universal health insurance is being debated as one remedy for such health inequalities. This article considers mechanisms through which SES affects health and argues that a broader and more comprehensive approach is needed.Data Sources.-Published articles surveyed using MEDLINE and review articles and bibliographies.Methods and Results.-Research is reviewed on the association of SES with health outcomes in different countries, including those with universal health coverage. Socioeconomic status relates to health at all levels of the SES hierarchy, and access to care accounts for little of this association. Other mechanisms are suggested and implications for policy and clinical practice are discussed.Conclusion.-Health insurance coverage alone is not likely to reduce significantly SES differences in health. Attention should be paid both in policy decisions and in clinical practice to other SES-related factors that may influence patterns of health and disease.