Long-Term Effects of Wealth on Mortality and Self-rated Health Status
Long-Term Effects of Wealth on Mortality and Self-rated Health Status
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DOI：
10.1093/aje/kwq348
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发表时间：
2011-01-15
影响因子：
5
通讯作者：
Thomas, James C.
中科院分区：
文献类型：
--
作者：
Hajat, Anjum;Kaufman, Jay S.;Thomas, James C.
流行病学研究很少将财富作为社会经济地位的组成部分。作者调查了财富与两项主要结果指标之间的关联：死亡率和自评总体健康状况。 1984 年至 2005 年间在美国人口中收集的收入动态纵向面板研究的数据用于拟合边际结构模型并估计相对和绝对效应指标。财富被指定为 6 类变量：财富 < 0 的变量和正财富的五分位数。相对于最富有的五分之一人群，较不富裕的人群的风险高出 16%-44%，并且健康状况不佳/一般的病例（每 1,000 人）多出 6-18 例。相对于富裕的同龄人，不太富裕的男性、女性和白人的健康状况不佳/一般的风险更高。总体财富与死亡率的关联显示，最不富有的人的风险增加了 62%，死亡人数超额增加 4 人（每 1,000 人）。较不富裕的女性的死亡风险要高出 24% 至 90%，而最不富裕的男性与最富有的五分之一人口相比，死亡风险高出 6 倍。总体而言，财富与不良健康状况以及财富与死亡率之间存在很强的负相关关系。
Epidemiologic studies seldom include wealth as a component of socioeconomic status. The authors investigated the associations between wealth and 2 broad outcome measures: mortality and self-rated general health status. Data from the longitudinal Panel Study of Income Dynamics, collected in a US population between 1984 and 2005, were used to fit marginal structural models and to estimate relative and absolute measures of effect. Wealth was specified as a 6-category variable: those with < 0 wealth and quintiles of positive wealth. There were a 16%-44% higher risk and 6-18 excess cases of poor/fair health (per 1,000 persons) among the less wealthy relative to the wealthiest quintile. Less wealthy men, women, and whites had higher risk of poor/fair health relative to their wealthy counterparts. The overall wealth-mortality association revealed a 62% increased risk and 4 excess deaths (per 1,000 persons) among the least wealthy. Less wealthy women had between a 24% and a 90% higher risk of death, and the least wealthy men had 6 excess deaths compared with the wealthiest quintile. Overall, there was a strong inverse association between wealth and poor health status and between wealth and mortality.