家庭社会经济地位与学龄前儿童注意缺陷多动障碍的相关研究

目的 了解学龄前儿童注意缺陷多动障碍(ADHD)的流行情况,分析家庭社会经济地位与ADHD发生的关系,为儿童ADHD的防控和干预提供科学依据。方法 采用方便整群抽样的原则,从农村地区的5所幼儿园和城市地区的2所幼儿园共抽取1 142名4~7岁的儿童,对其家长进行问卷调查。采用《ADHD评估量表(第4版)-学龄前儿童版》评估ADHD的症状水平。结果 学龄前儿童ADHD症状阳性率为7.01%,男童检出率为7.38%,女童检出率为6.56%。农村地区检出率为7.99%,城市地区为6.67%。多因素分层回归显示,女童、父亲年龄较大者,家里儿童读物数量较多者,ADHD症状水平较低。此外,3岁后每年生活总花费较高者,其ADHD症状阳性率越高,这种趋势主要表现在城市儿童中,农村儿童则相反。结论 家庭社会经济地位,特别是对学龄前儿童生活的投入与儿童ADHD密切相关,但是城乡差异和儿童年龄差异在其间起重要的调节作用。     

青岛市城区学龄前儿童观看电视与行为问题的相关研究

【目的】探讨电视等因素与学龄前儿童行为问题的相关性。【方法】采用自制家庭一般环境问卷、Achenbach儿童行为量表（CBCL）对469名4～5岁儿童进行调查，研究家庭一般环境因素、观看电视对儿童行为问题及其各因子的影响，统计方法采用Pearson相关、多元逐步回归分析。【结果】①儿童行为问题发生率为16．9％，男女儿童差异无显著性（X^2=0．179，P〉0．05）；②男童看体育节目和警匪片的比例多于女童（x^2=6．334、6．276；P〈0．05，0．01）女童看电视连续剧的比例多于男童（x^2=14．075，P〈0．01）；③Pearson相关分析示：男童平日观看电视时间与各行为因子分正相关（r=0．130-0．213，P=0．04～0．001），但是女童观看电视时间与其行为问题无相关性；④多元逐步回归分析显示：男童观看电视时间和内容与多种行为问题分相关（r=0．142-0．205，P=0．001-0．024）。喂养方式、家庭经济收入、居室面积和父亲的文化水平与儿童行为问题相关。【结论】男童观看电视时间和内容与其行为问题密切相关；家庭环境因素与4～5岁儿童的行为问题密切相关。     

Effects of socioeconomic status on patients' outcome after total knee arthroplasty.

OBJECTIVE: To identify whether patients in lower socioeconomic groups had worse pain and functional levels prior to total knee arthroplasty and then establish whether these patients had poorer post-operative outcomes following total knee arthroplasty. METHOD: Data was obtained from a prospective observational study of 974 patients undergoing primary total knee arthroplasty for osteoarthritis. The study was undertaken in 13 centers in 4 countries. Pre-operative data was collected and patients were followed for 2 years post-operatively. Pre-operative details of the patients' demographics; socioeconomic status (SES) (education and income); height; weight and co-morbid conditions were obtained. The WOMAC scores were obtained preoperatively and during follow-up. RESULTS: Using multivariate linear regression analysis, patients with a lower income had a significantly worse pre-operative WOMAC Pain (P = 0.021) and function score (P = 0.039) than those with higher incomes. However, income did not have a significant impact on outcome at final follow-up after adjusting for other significant covariates. Level of education did not correlate with pre-operative scores or with outcome at any time during follow-up. CONCLUSION: Across all four countries, patients with lower incomes appeared to have a greater need for total knee arthroplasty. However, level of income and educational status did not appear to affect the final outcome following total knee arthroplasty. Patients with lower incomes appeared able to compensate for their worse pre-operative score and obtain similar outcomes post-operatively. These findings are in contrast to studies on other medical conditions and surgical interventions, in which a lower SES has been found to have a negative impact on patient outcomes.     

家庭社会经济地位和主观社会经济地位对精准扶贫家庭学生抑郁症状的影响

目的 探讨家庭社会经济地位和主观社会经济地位对精准扶贫家庭学生抑郁症状的影响。方法 采用家庭社会经济地位问卷、青少年主观社会地位量表和流调用抑郁自评量表对450名精准扶贫家庭学生进行调查。结果 （1）可能有抑郁症状的占17.4%,有抑郁症状的占57.3%;（2）家庭社会经济地位对主观社会经济地位有正向预测作用（B = 0.19,P＜0.001）,对抑郁症状的预测作用无统计学意义（B = 0.04,P＞0.05）,主观社会经济地位对抑郁症状有负向预测作用（B = - 0.28,P＜0.001）;（3）主观社会经济地位在家庭社会经济地位和抑郁症状之间起完全中介作用,中介效应值为0. 05(95%CI:- 0.09～- 0.02)。结论 精准扶贫家庭学生抑郁症状的检出率较高,家庭社会经济地位主要通过主观社会经济地位影响抑郁症状。     

中国居民吸烟与社会经济状况关系研究

目的　探讨中国不同社会经济状况居民的吸烟情况 ,以期为国家控烟战略与措施提供科学依据。方法　采用横断面研究。资料来源于中国卫生部统计信息中心 1998年第 2次国家卫生服务调查数据库。结果　无论在男性、女性人群均表现为文化程度越高吸烟率越低 (P <0 0 0 0 1) ;不同职业人群中 ,吸烟率最低的是专业技术人员 (男性为 5 1 5 0 % ,女性为 2 2 3% ) ;吸烟率最高的分别是 :男性制造、生产、运输人员 (6 3 94 % ) ;女性林、牧、渔业人员(5 6 8% ) ;由低收入到高收入 ,城镇男性的吸烟率逐渐下降 ,农村男性吸烟率接近但吸烟量增大。结论　目前中国吸烟现象较为严重且主要集中在社会经济地位低下的人群中 ,提示国家控烟战略与措施应有针对性的在这部分人群中开展。     

Effects of socioeconomic status on breastfeeding duration in mothers of preterm and term infants

BACKGROUND: The propensity to breastfeed is not only of importance with regard to the beneficial effects on the individual, but is also of concern as an indicator of health behaviour related to social conditions. Thus, our aim was to investigate the impact of socioeconomic status (SES) on breastfeeding duration in mothers of preterm and term infants. METHODS: Prospective population based cohort study. Data for infants registered in breastfeeding databases of two Swedish counties 1993-2001 were matched with data from two national registries-the Medical Birth Registry and Statistics Sweden. A total of 37,343 mothers of 2093 preterm and 35,250 term infants participated. RESULTS: All socioeconomic factors; maternal educational level, maternal unemployment benefit, social welfare and equivalent disposable income, were strongly associated with breastfeeding when examined individually in mothers of preterm and term infants. Some of the associations attenuated when investigated simultaneously. Independently of SES and confounders, mothers of preterm infants were at higher risk of weaning before the infant was 2 months (adjusted odds ratio (OR) 1.70; 95% confidence interval ((CI) 1.46-1.99)), 4 months (OR 1.79; CI 1.60-2.01), 6 months (OR 1.48; CI 1.33-1.64), and 9 months old (OR 1.19; CI 1.06-1.34), compared with mothers of term infants. CONCLUSIONS: In Sweden, despite its social welfare support system and a positive breastfeeding tradition, SES clearly has an impact on the breastfeeding duration. Mothers of preterm infants breastfeed for a shorter time compared with mothers of term infants, even when adjustments are made for SES and confounders.     

Sex differences in sexuality among medical students: Effects of increasing socioeconomic status

Research has consistently shown that, compared to men, women are more cautious and selective and maintain greater marital aspirations in entering and maintaining sexual relationships. One explanation of this sex difference is that women have traditionally had inferior access to earning power and social status and consequently were forced to acquire socioeconomic status (SES) through their choice of marriage partners. A contrasting view is that this difference is a component of the basic sex difference identified in the Kinsey studies: Men are more likely than women to dissociate coitus from emotional attachment and to desire and seek coitus with a variety of partners. These two explanations were explored in open-ended interviews with matched samples of 20 male and 20 female medical students. The results were more consistent with the perspective of basic sex differences than with the differential resources explanation. Increasing female SES does not appear to eliminate or even substantially reduce this sex difference. Increasing SES tends to enlarge the pool of acceptable, available sexual and marital partners for men while it tends to reduce the pool for women. Increasing SES thus tends to have different effects on men and women and may cause sex differences in the tendency to associate coitus with emotional attachments and marital aspirations to be more, rather than less, apparent. Extensive case data with verbatim quotations are presented to reveal the emotions and desires underlying subjects' overt behavior.     

社会经济地位对居民健康公平的影响

社会经济地位指个人或群体在阶级社会中的位置?社会经济地位是职业、教育、收入、财富以及居住地区等指标的综合反映。社会学家常用社会经济地位作为预测人们行为的一种手段与方式。据对社会经济地位与居民健康状况有关的研究发现：收入差距与健康密切相关；社会经济地位与健康之间有一个梯度关系，而且这并不是只发生在贫困层面；医疗保健服务对健康差距产生的作用比较小；社会经济因素通过多种渠道影响居民的健康状况。     

Influences on women's smoking status: The contribution of socioeconomic status in adolescence and adulthood

Background: Declining smoking prevalence is associated withwidening socioeconomic differentials in tobacco use. The studyinvestigates the influence of the adolescent and adult socioeconomicenvironment on the smoking status of adult women. Methods: Asecondary data analysis of a nationally representative surveyof households in Britain, the British Household Panel Survey,was undertaken of 2,678 non-Asian women aged 18–49 yearsin 1991. Multivariate analysis confirmed the significant andindependent effect of adolescent and adult SES on the odds ofbeing a current smoker. Results: With respect to adolescentSES, school-leaving age and school qualifications exerted anindependent effect. With respect to current SES, housing tenurewas the strongest predictor of smoking status. Along with livingin rented housing, other markers of current disadvantage alsoincreased the odds of being a current smoker, including livingin a household without access to a car and being dependent onmeans-tested benefits. Not living with a partner also increasedthe odds of smoking. Compared to Black women, White women wereover twice as likely to be a current smoker. Conclusions: Publichealth policies to reduce the socioeconomic gradient in smokingamong women should target both adolescence and adulthood. Investmentin the education of children heading towards early school leavingand minimum school qualifications could yield positive healthdividends in later life, in terms of higher SES and lower smokingprevalence. Interventions to raise the living standards of womenin lower socioeconomic groups may be required if they are tomatch the rates of decline achieved among women in more advantagedcircumstances.     

Effects of potential partners' physical attractiveness and socioeconomic status on sexuality and partner selection

Male (n= 170) and female (n= 212) college students viewed photographs, which had been prerated for physical attractiveness, of three opposite-sex individuals. These photographs were paired with three levels of occupational status and income. Subjects indicated their willingness to engage in relationships of varying levels of sexual intimacy and marital potential with the portrayed individuals. Analyses of variance, correlations, and trend analyses supported the hypotheses. Compared to men, women are more likely to prefer or insist that sexual intercourse occur in relationships that involve affection and marital potential, and women place more emphasis than men do on partners' SES in such relationships. Consequently, men's SES and their willingness and ability to invest affection and resources in relationships may often outweigh the effects of their physical attractiveness in women's actual selection of partners. These results and the literature reviewed are more consistent with parental investment theory than with the view that these sex differences are solely the result of differential access to resources and differential socialization.     

我国居民看电视时间的分析

目的了解我国居民看电视的现状,为制定干预措施提供基础资料。方法使用2002年中国居民营养与健康状况调查数据,对我国6岁及以上居民66601人(男性32254人,女性34347人)的看电视情况进行分析。结果92.1%的居民看电视,城市居民(94.3%)看电视的比例高于农村(91.2%),男性(93.0%)高于女性(91.2%),18~59.9岁居民高于其他年龄组居民。居民平均每星期看电视的时间是2.1小时,其中城市(2.3小时)高于农村(2.0小时),18岁及以上居民高于18岁以下居民,男女间差别不大。平均每天看电视时间小于1小时、1~2小时、2~3小时、3小时及以上的居民所占比例依次为13.9%、25.5%、34.6%和26.0%。结论我国6岁以上居民绝大多数看电视,看电视时间2小时及以上的居民所占比例比较高,不同年龄、性别、城乡居民看电视时间存在差异。     

Quality children's television: the case of “Lift Off”

“Lift off” is a new, innovative children's television series produced by the Australian Children's Television Foundation. It has been well received by critics, parents, educators and most significantly, by its three-to-eight year old target audience.

The program easily satisfies the five criteria for quality programming formulated by the Children's Program Committee of the Australian Broadcasting Tribunal. The typical half-hour program is dense, requiring close viewer attention but it is claimed that the viewer is rewarded for her viewing investment with an enriching and pleasurable experience. The doubt is raised that the socially disadvantaged segment of the child audience, who use television for diversion rather than enrichment, may not be prepared to make such an investment of viewing attention.

One final concern is voiced. The Foundation's official spokespeople publicly claim that “Lift Off” will enrich the lives of a whole age cohort. It is argued that such claims overemphasise the supposed direct consequences and impact of media messages on individuals.     

Physician visits, hospitalizations, and socioeconomic status: ambulatory care sensitive conditions in a canadian setting

OBJECTIVE: To determine whether rates of physician visits for ambulatory care sensitive (ACS) conditions are lower for people of low-socioeconomic status than of high-socioeconomic status in an urban population with universal health care coverage. DATA SOURCES/STUDY SETTING: Physician claims and hospital discharge abstracts from fiscal years 1998 to 2001 for urban residents of Manitoba, Canada. The 1996 Canadian Census public use database provided neighborhood household income information. The study included all continuously enrolled urban residents in the Manitoba Health Services Insurance Plan. STUDY DESIGN: Twelve ACS conditions definable using 3-digit ICD-9-CM codes permitted cross-sectional and longitudinal comparison of ambulatory visits and hospitalizations. Neighborhood household income data provided a measure of socioeconomic status. DATA COLLECTION/EXTRACTION METHODS: Files were extracted from administrative data housed at the Manitoba Centre for Health Policy. PRINCIPAL FINDINGS: All conditions showed a socioeconomic gradient with residents of the lowest income neighborhoods having both more visits and more hospitalizations than their counterparts in higher income areas. Six of nine conditions with a sufficient N showed individuals living in the lowest income neighborhoods to have significantly more ambulatory visits before hospitalization for an ACS condition than did those in the most affluent neighborhoods. Many conditions showed a gradient in rate of hospitalization even after controlling for the number of ambulatory care visits. CONCLUSIONS: In the Canadian universal health care plan, the poor have reasonable access to ambulatory care for ACS conditions. Ambulatory care may be more effective in preventing hospitalizations among relatively affluent individuals than among the less well off.     

居民社会经济状况与心血管病危险因素的关系

目的 探讨居民社会经济状况(Socioeconomic Status，SES)和心血管病危险因素之间的关系，为干预的重点人群的确定提供科学依据。方法 利用1997年及1998年广东省糖尿病流行病学调查资料分析社会经济状况和心血管病危险因素之间的关系。结果 男性的社会经济状况指标优于女性。调整年龄、职业性体力活动、休闲体力活动和饮酒后，SES对心血管病危险因素仍有影响，其中受教育程度和居住地区的影响较大，其关联在男女不同。结论 社会经济状况是心血管病危险因素的重要影响因子，对社会经济状况好的女性施加干预可能会取得更好的效果。     

Healing the poor: The influence of patient socioeconomic status on physician supply responses

A longstanding literature explores how altruism affects the way physicians respond to incentives and provide care. We analyze how patient socioeconomic status mediates these responses. We show theoretically that patient socioeconomic status systematically influences the way physicians respond to reimbursement changes, and we identify the channels through which these effects operate. We use two Medicare reimbursement changes to investigate these insights empirically. We confirm that a given physician facing an increase in reimbursement boosts utilization by more when treating richer patients. We show that average supply price elasticities vary from 0.02 to 0.18 for a given physician, depending on the patient’s socioeconomic status. Finally, we show that the Medicare reforms we study led to overall reimbursement increases that raised healthcare utilization by 10% more for high-income patients compared to their low-income peers.     

Impact of socioeconomic status on coronary mortality in people with symptoms, electrocardiographic abnormalities, both or neither: the original Whitehall study 25 year follow up

OBJECTIVES: To determine the impact of socioeconomic status (SES) on coronary heart disease (CHD) mortality in people with and without prevalent CHD at baseline. DESIGN: Cohort study with 25 year follow up; prevalent CHD was defined by Q, ST or T wave electrocardiographic (ECG) abnormalities or symptoms (defined by the Rose chest pain questionnaire and self reported doctor diagnosis) or both. SES was defined by four civil service employment grades. SETTING: London. PARTICIPANTS: 17 907 male civil servants aged 40-69 years. MAIN OUTCOME MEASURES: CHD mortality (n=2695 deaths). RESULTS: The lowest versus highest employment grade was associated with increased CHD mortality (age adjusted hazard ratio 1.56 (95% CI 1.2, 2.1)), prevalence of symptoms and, among symptomatic participants only, the prevalence of Q, ST or T abnormalities. Thirty one per cent of CHD deaths occurred in participants with prevalent CHD at baseline. Among participants without Q, ST or T abnormality employment grade was associated with CHD mortality; the hazard ratios (lowest v highest grade) adjusted for age, systolic and diastolic blood pressure were 1.72 (95% CI 1.4, 2.1) for asymptomatic and 1.52 (95% CI 1.1, 2.1) for symptomatic participants; among participants with Q, ST or T abnormality the corresponding hazard ratios were 1.46 (95% CI 0.7, 2.9) and 1.14 (95% CI 0.6, 2.0) respectively. CONCLUSIONS: SES was inversely associated with CHD mortality in civil servants with and without prevalent CHD at baseline. Further distinguishing the relative contribution of SES to the initiation and progression of CHD requires repeated measures studies of pre-clinical and clinical measures of CHD.