Accumulation, health and health inequalities. The importance of life course processes and risk profiles

关于保健不平等原因的知识仍然有限。因此，在前一个项目中，物质、社会心理和行为因素以及不同的生命过程过程被分开和联合研究。我们能够确认这些单一因素和过程的相关性，并表明联合分析提供了创新的发现。因此，积累过程已被证明是健康不平等背后的一个关键机制。到目前为止，它们还没有被广泛地研究以区分适应过程。此外，缺乏对可能的“风险概况”的检查，这导致同时暴露于多种（不利）因素。后续项目的总目标是通过在横断面和纵向分析中纳入物质、社会心理和行为因素，调查积累过程在产生保健不平等中的重要性。该项目将解决以下研究问题：1。物质和社会心理因素暴露对健康的影响如何随暴露时间而变化（纵向视角）？2. 积累和适应过程的相对重要性在社会经济地位群体和生命阶段之间有多大差异，这些差异是否有助于解释健康不平等？3. 从（横截面的角度）可以确定哪些具有特定中间因素组合的风险概况？这些风险概况在多大程度上因性别和年龄而不同？它们与健康和健康不平等有何关联？分析将基于德国社会经济委员会1994年至2017年的数据。固定效应回归将用于分析积累和适应过程对解释健康不平等的重要性。风险概况的确定将使用潜在类别分析进行，提取聚类解释因素的特定模式。该项目将为卫生不平等现象产生背后的机制提供新的见解。通过同时考虑生命过程和解释各种因素，将弥补国内和国际在分析健康不平等方面存在的差距。

Knowledge about the causes of health inequalities is still limited. Thus, material, psychosocial and behavioural factors as well as different life course processes were studied separately and jointly in the predecessor project. We were able to confirm the relevance of these single factors and processes and to show that the joint analysis provided innovative findings. Hereby, accumulation processes have proven to be a key mechanism behind health inequalities. Until now, they have not been widely studied in distinction to adaption processes. Furthermore, an examination of possible “risk profiles” is lacking, which result in a simultaneous exposure to multiple (dis-)advantageous factors. The overall aim of the follow-up project is to investigate the importance of accumulation processes in the generation of health inequalities by including material, psychosocial and behavioural factors in cross-sectional and longitudinal analyses. The project will address the following research questions: 1. How do the health effects of exposure to material and psychosocial factors change with duration of exposition (longitudinal perspective)? 2. To what extent does the relative importance of accumulation and adaption processes vary between socioeconomic status groups and life phases and do these differences contribute to the explanation of health inequalities? 3. Which risk profiles with specific combinations of intermediate factors can be identified for Germany from (cross-sectional perspective)?4. To what extent do these risk profiles differ with regard to gender and age and how are they associated with health and health inequalities? The analyses will be based on data from the German Socio-Economic Panel using the years 1994 to 2017. Fixed effects-regressions will be used to analyse the importance of accumulation and adaption processes for the explanation of health inequalities. The determination of the risk profiles will be carried out using Latent-Class-Analysis, extracting specific patterns of clustered explaining factors. This project will provide new insights on the mechanisms behind the emergence of health inequalities. By simultaneously considering life course processes and explaining factors, the nationally and internationally existing gap in analysing health inequalities will be met.