Measuring social gradients in health, lifestyles, and health seeking behavior of children in developing countries

近年来，有报道称，健康方面存在社会梯度。在发展中国家，由于获得医疗保健的机会、营养食品的可获得性、生活条件各不相同，各社会阶层在健康状况、生活方式和医疗保健使用方面的差异尚未得到阐明。健康促进干预有时会扩大贫富之间的健康差距。这项研究的目的是调查发展中国家儿童健康的社会梯度。对5岁以下儿童的身高和体重、吸烟行为、结核病患者的医疗保健以及软骨病的发病率和治疗情况的检查显示，不同国家有不同的模式。在健康存在社会梯度的地区，一般健康促进干预不利于缩小贫富差距。应针对所有年龄组和性别，在健康、生活方式、获得保健服务方面实现平等。健康状况或行为与社会阶层之间的联系因国家而异。在制定干预措施时，应考虑按年龄、性别和居住地划分的健康梯度。

The existence of social gradients in health has been reported in recent years. In developing countries, where access to healthcare, availability of nutritious food, living conditions vary, differences across social class in health status, lifestyles, and healthcare use had not been elucidated. Health promotion interventions sometimes widen disparities of health between rich and poor. The objective of this study was to investigate social gradients in health of children in developing countries. Examination on height and weight of under 5 year old children, smoking behavior, healthcare of tuberculosis patients, and morbidity and treatment of Rickets revealed different patterns according to the countries. In the areas the social gradients in health exist, general health promotion intervention did not contribute to reduce the gap between the rich and poor. Equity in health, lifestyles, access to healthcare services should be addressed to all age groups and gender. The association between health status or behavior and social class varied by countries. Gradients in health by age, gender, and area of residence should be considered to develop interventions.