Mediation Role of Social Relationships in the Association Between Socioeconomic Position and Health/0ral Health

社会关系在社会经济地位与健康/0ral健康关联中的中介作用

• 批准号: 2074488
• 金额: --
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2074488
• 关键词: Mediation; Role; Social; Relationships; Association

IntroductionSocial inequalities in health are universally recognised as a major public health problem (WHO, 2008). Explanations for health inequalities include material, behavioural and psychosocial pathways. Whilst material and behavioural pathways have been studied extensively, few studies have explored the contribution of social relationships to social gradients in health. The term 'social relationships' is an umbrella term including concepts of social networks and social support. The importance of social relationships for health and well-being is well established (Holt-Lunstad et al., 2010; Berkman and Krishna 2014), and there is evidence that access to social networks and social support is influenced by socioeconomic position (House et al., 1988; Taylor and Seeman, 1999). Individuals who face socioeconomic disadvantage throughout life have been found to become less socially active after retirement to face limiting illnesses earlier than their more affluent peers (Blane et al., 2007). Given the evidence that social engagement and social connectedness are important determinants of health, it would be imperative to understand whether social relationships also contribute to social inequalities in health and healthy ageing - an area that remains less well understood. The limited number of existing studies that examine the mediating role of social relationships on health inequalities have mainly looked at mortality and cardiovascular disease, however results have been contradictory (Marmot et al, 1998; von dem Knesebeck, 2005; Stringhini et al., 2012; Wang et al., 2015; McCrory et al., 2016; Aartsen et al, 2017; Gorman and Sivaganesan, 2017). Aims/ObjectivesThe proposed research aims to examine the mediating role of social relationships on the association between socioeconomic position and health. The following objectives will be addressed:1. To assess the social gradients in health outcomes 2. To assess whether social relationships are linked to socioeconomic inequalities in health3. To assess how much of the socioeconomic gradient in health is explained by structural and functional social relationshipsHypothesisIt is hypothesised that social relationships mediate the association between socioeconomic position and health. Methodology: I propose to use data from the UK English Longitudinal Study of Ageing (ELSA), to examine the dynamics of social relationships and their influence on health inequalities across older age. The following health outcomes will be considered: self-rated health, self-rated oral health and difficulties, physical function and cognitive function. ELSA is a rich dataset containing measures on socioeconomic position (education, income, wealth) and social relationships (social networks/cohesion, social support, loneliness). The hypothesised pathways will be tested using regression models and structural equation modelling.The findings of proposed project could inform policy interventions aimed at reducing social inequalities in health through promotion of active participation and social cohesion.

健康方面的社会不平等被普遍认为是一个主要的公共卫生问题（世卫组织，2008年）。对健康不平等的解释包括物质、行为和心理社会途径。虽然物质和行为途径已被广泛研究，但很少有研究探讨社会关系对健康社会梯度的贡献。术语“社会关系”是一个总括术语，包括社交网络和社会支持的概念。社会关系对健康和幸福的重要性是公认的（Holt-Lunstad等人，二○一○年; Berkman and Krishna 2014），并且有证据表明，社会经济地位会影响对社交网络和社会支持的访问（House et al.，1988; Taylor和Seeman，1999）。已经发现，在一生中面临社会经济劣势的个人在退休后变得不那么活跃，比他们更富裕的同龄人更早地面临限制性疾病（Blane等人，2007年）。有证据表明，社会参与和社会联系是健康的重要决定因素，因此必须了解社会关系是否也助长了健康和健康老龄化方面的社会不平等-这是一个仍然不太清楚的领域。现有的有限数量的研究，审查社会关系对健康不平等的中介作用，主要是看死亡率和心血管疾病，但结果是矛盾的（Marmot等人，1998年; von dem克内塞贝克，2005年; Stringhini等人，2012; Wang等人，2015; McCrory等人，2016; Aartsen等人，2017; Gorman和Sivaganesan，2017）。目的/ObjectivesThe拟议的研究旨在探讨社会关系的社会经济地位和健康之间的关联的中介作用。将解决以下目标：1。评估健康结果的社会梯度2。评估社会关系是否与健康方面的社会经济不平等有关3。为了评估健康的社会经济梯度有多少是由结构和功能的社会关系hypothesisIt是假设，社会关系介导的社会经济地位和健康之间的关联。方法学：我建议使用英国老龄化纵向研究（艾尔莎）的数据，研究社会关系的动态及其对老年人健康不平等的影响。将考虑以下健康结果：自评健康、自评口腔健康和困难、身体功能和认知功能。艾尔莎是一个丰富的数据集，包含社会经济地位（教育，收入，财富）和社会关系（社交网络/凝聚力，社会支持，孤独）的措施。将使用回归模型和结构方程模型对假设的途径进行测试，拟议项目的结果可以为旨在通过促进积极参与和社会凝聚力减少健康方面社会不平等的政策干预提供信息。