FOR 2723: Understanding the institutional context of health inequalities among young people. A life stage approach

青年人的健康与他们的社会经济背景密切相关。虽然儿童和青少年健康不平等的描述性证据令人信服，但对根本机制的探讨要少得多。最好的，虽然不完整，证据存在的个人层面的因素，调解社会经济环境和健康之间的关系。只有很少的人知道在语境层面上的解释因素。例如，机构环境在规模、组成、基础设施、类型和质量方面的特点，很可能在个人层面的决定因素之外，对青年人健康方面的社会经济不平等产生影响。因此，需要在个人和背景层面上综合证据，说明健康方面社会经济不平等的可能驱动因素，以阐明年轻人的健康不平等，并帮助设计有效的多层次干预措施来解决这些不平等问题。汇集来自不同研究背景的团队，该单位将创建一个卓越的集群，允许解决这个研究课题的复杂性。我们将明确超越以往的研究尝试，a）应用严格的生命阶段方法，考虑从出生到成年早期的不同生命阶段的特殊性，B）专注于年轻人和他们所处的制度环境之间的相互作用。一般研究目标是：1）系统地审查现有的国际证据，说明不同的体制环境对一般健康的影响，特别是对儿童到成年早期健康方面的社会经济不平等的影响。2)实证研究德国不同制度环境的特征是否以及如何与个人层面健康不平等的出现相关联。3）将不同子项目的研究结果整合到一个关于个人和环境层面关键机制的单一综合理论模型中。在对现有证据进行审查的基础上，研究组在首个资助期内会主要分析二手资料。这些分项目将侧重于作为社会主要社会化媒介的环境，如家庭、幼儿园、学校、高等教育/工作以及保健系统，这些对健康发展起着关键作用。该项目结合了不同分析层次的解释性因素和机制，并考虑到不同生命阶段和体制背景下的具体解释。该研究单位将大大有助于在社会学、社会流行病学和公共卫生的界面上，对整个生命过程中的健康不平等现象实施跨学科的多层次观点。

The health of young people is strongly linked to their socioeconomic background. While the descriptive evidence of health inequalities among children and adolescents is convincing, the underlying mechanisms have been far less explored. The best, though incomplete, evidence exists for individual-level factors which mediate the relationship between socioeconomic circumstances and health. Only little is known about explanatory factors at contextual level. For example, characteristics of institutional contexts in terms of size, composition, infrastructure, type and quality are likely to shape socioeconomic inequalities in health among young people above and beyond individual-level determinants. Thus, combined evidence on possible drivers of socioeconomic inequalities in health both at the individual and the contextual level is needed to elucidate health inequalities at younger ages and help to design effective multilevel interventions to tackle these inequalities.The aim of the research unit is to substantially improve the understanding of the development of health inequalities at younger ages. Bringing together teams from various research backgrounds, the unit will create a cluster of excellence that allows to address the complexity of this research topic. We will explicitly go beyond previous research attempts by a) applying a strict life stage approach that considers the particularities of the different life stages from birth to early adulthood and b) focussing on the interplay between young people and the institutional contexts in which they act. The general research objectives are:1) To systematically review existing international evidence on the impact of different institutional contexts on health in general and on socioeconomic inequalities in health in particular from childhood to early adulthood. 2) To empirically study whether and how characteristics of different institutional contexts in Germany are associated with the emergence of individual-level inequalities in health.3) To integrate findings from the different subprojects into a single and comprehensive theoretical model about the key mechanisms at individual and contextual levels.Building upon reviews of the existing evidence, the research unit will mainly analyse secondary data in the first funding period. The subprojects will focus on the contexts that serve as major socialisation agents in society, such as the family, kindergarten, school, tertiary education/work as well as the health care system, which plays a key role for a healthy development. The project combines explanatory factors and mechanisms at different levels of analysis and takes into account the specific explanations at the different life stages and institutional contexts. The research unit will substantially contribute to the implementation of an interdisciplinary multilevel perspective on health inequalities across the life course at the interface of sociology, social epidemiology and public health.