Socioeconomic disparities and health: impacts and pathways.
Socioeconomic disparities and health: impacts and pathways.
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DOI：
10.2188/jea.je20110116
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发表时间：
2012
影响因子：
4.7
通讯作者：
Kondo N
中科院分区：
文献类型：
--
作者：
Kondo N
日益扩大的社会经济差距是一个全球关注的问题，因为它可能会影响人口健康。作者和同事调查了社会经济差异对健康的影响，以及这些差异背后的途径。我们的荟萃分析发现，大量人口存在死亡风险和自我评价较差的健康状况，这些都可归因于收入不平等。研究结果还表明，存在门槛效应(即收入不平等的门槛，超过这个门槛对健康的不利影响增加)、周期效应(即在以后几年，特别是在20世纪90年代之后可能产生更大的影响)，以及收入不平等和健康结果之间的滞后效应。我们的其他研究使用了日本全国代表性调查数据和对日本老年人(年龄群)的大规模队列研究，支持相对剥夺假说，即不平等社会中因相对剥夺而产生的令人反感的社会比较对健康不利。一项采用自然实验设计的研究发现，由于中产阶级白领和中高收入工人的健康改善较小，自评健康的社会经济梯度实际上可能在1997-98年日本经济危机后变得更浅。总而言之，收入不平等可能对个人健康产生不利影响，而相对剥夺造成的心理社会压力可能部分解释了这些影响。任何关于宏观经济波动对健康差距的影响的研究都应该考虑多种可能的途径，包括扩大收入不平等、劳动力市场的变化和社会资本的侵蚀。需要进一步研究，以便更好地了解在一个快速变化的社会中健康的社会决定因素。
Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997–98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society.
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影响因子：
5.4
作者：
Kondo, Naoki;Kawachi, Ichiro;Subramanian, S. V.;Takeda, Yasuhisa;Yamagata, Zentaro
通讯作者：
Yamagata, Zentaro
影响因子：
3.5
作者：
Jones, Andrew M.;Wildman, John
通讯作者：
Wildman, John
DOI：
10.1136/bmj.b4471
发表时间：
2009-11-10
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Kondo N;Sembajwe G;Kawachi I;van Dam RM;Subramanian SV;Yamagata Z
通讯作者：
Yamagata Z
影响因子：
5.5
作者：
Subramanian, SV;Kawachi, I
通讯作者：
Kawachi, I
影响因子：
2.1
作者：
Lorgelly, Paula K.;Lindley, Joanne
通讯作者：
Lindley, Joanne