The resources that matter: Fundamental social causes of health disparities and the challenge of intelligence
The resources that matter: Fundamental social causes of health disparities and the challenge of intelligence
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DOI：
10.1177/002214650804900106
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发表时间：
2008-03-01
影响因子：
5
通讯作者：
Westin, Emily Leckman
中科院分区：
文献类型：
--
作者：
Link, Bruce G.;Phelan, Jo C.;Westin, Emily Leckman
社会经济状况指标(SES)与威胁生命的疾病的发病之间存在着牢固而持久的联系，这是医学社会学的一个突出问题。随着时间的推移，这种联系的持久性及其在非常不同的地方的普遍性表明，没有一组固定的介入性风险和保护因素可以解释这种联系。相反，根本原因理论将与SES相关的知识、金钱、权力声望和有益的社会关系资源视为灵活的资源，使人们能够规避风险并采取保护策略，而无论给定地点或时间的风险和保护因素是什么。然而，最近，情报被提议作为一种灵活的替代资源，可以完全解释SES和健康之间的联系，从而找到它作为流行病学家“难以捉摸的根本原因”的位置(Gottfredson 2004)。我们在包含智力、SES和健康测量的两个数据集中检验了智力测试分数和成人SES的直接影响。在对威斯康星纵向研究和健康与退休调查的预期数据进行分析时，我们发现，在成人教育和收入保持不变的情况下，几乎没有证据表明智力对健康有直接影响。相比之下，当智力被控制时，教育和收入对健康的显著影响变化很小。尽管数据限制不能最终解决这个问题，但这一证据与情报是难以捉摸的根本原因的说法不一致。她指出，这是一项消除健康差距的政策，支持人们积极利用灵活的资源获得健康优势的观点，这些资源是与社会经济地位相关的知识、金钱、权力、声望和有益的社会关系资源。
A robust and very persistent association between indicators of socioeconomic status (SES) and the onset of life-threatening disease is a prominent concern of medical sociology. The persistence of the association over time and its generality across very different places suggests that no fixed set of intervening risk and protective factors can account for the connection. Instead, fundamental-cause theory views SES-related resources of knowledge, money, power prestige, and beneficial social connections as flexible resources that allow people to avoid risks and adopt protective strategies no matter what the risk and protective factors are in a given place or time. Recently, however, intelligence has been proposed as an alternative flexible resource that could fully account for the association between SES and health and thereby find its place as the epidemiologists' "elusive fundamental cause " (Gottfredson 2004). We examine the direct effects of intelligence test scores and adult SES in two data sets containing measures of intelligence, SES, and health. In analyses of prospective data from both the Wisconsin Longitudinal Study and the Health and Retirement Survey, we find little evidence of a direct effect of intelligence on health once adult education and income are held constant. In contrast, the significant effects of education and income on health change very little when intelligence is controlled. Although data limitations do not allow a definitive resolution of the issue, this evidence is inconsistent with the claim that intelligence is the elusive fundamental cause. of health disparities, and instead supports the idea that the flexible resources people actively use to gain a health advantage are the SES-related resources of knowledge, money, power, prestige, and beneficial social connections.