Divided we fall
Divided we fall
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分裂则亡
DOI：
10.1136/bmj.308.6937.1113
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
R. Wilkinson
中科院分区：
文献类型：
--
作者：
R. Wilkinson
穷人为他们的健康付出了社会不平等加剧的代价
在英国，与许多其他国家一样，与较低的社会地位相关的超额死亡率的规模使几乎所有其他健康问题相形见绌。白厅的研究表明，最初级的办公室工作人员的全因死亡率是在同一政府办公室工作的最高级别工作人员的三倍，病假率是最高级别工作人员的六倍。2本周的期刊Phillimore和他的同事们报告说，在英格兰北部地区最贫穷的选区，0-年龄段的死亡率是最富裕选区的四倍。作为社会经济因素对服务需求影响的一个指标，人口人均处方数量的区域差异有四分之三以上与区域失业水平的差异有关。
如果暴露在有毒物质中造成如此大的风险，那么办公室将被关闭，居民将从受污染的地区撤离。Phillimore和他的同事报告的这项研究表明，人口中更贫困的部分为官方未能认真对待疾病的社会原因付出了沉重的代价。尽管…
The poor pay the price of increased social inequality with their health
In Britain, as in many other countries, the scale of the excess mortality associated with lower social status dwarfs almost every other health problem. The Whitehall study hasshown that the most junior office staff have three times the all cause mortality and six times the sickness absence rates of the most senior staff working in the same government offices.1 2 In this week's journal Phillimore and colleagues report that mortality in those aged 0-64 years is four times higher in the poorest than in the most affluent electoral wards of the Northern region of England. As an indicator of the effect of socioeconomic factors on the demand for services, over three quarters of the regional variation in the number of prescriptions provided per head of population is associated with differences in regional levels of unemployment.3
If risks as great as these resulted from exposure to toxic materials then offices would be closed down and populations evacuated from contaminated areas. The research reported by Phillimore and colleagues suggests that the more deprived sections of the population have paid a heavy price for the official failure to take the social causes of disease seriously. Although the …