社会经济地位、健康生活方式与高血压发病的前瞻性队列研究

目的  探讨社会经济地位(socioeconomic status, SES)、健康生活方式与高血压发病的关系,为高血压的防控提供参考依据。方法  采用分层整群随机抽样于2010年对抽取的贵州省12个县(市、区)≥18岁常住居民共9 280人进行基线调查,于2016—2020年对该队列所有人群进行随访;采用t检验、χ²检验进行单因素分析,使用Cox比例风险回归模型分析SES、健康生活方式对高血压发病的影响。结果  研究有效样本量为3 401人,高血压发病765人,人群高血压发病密度为32.53/1 000人年。多因素Cox回归结果显示：与低SES(＜9分)人群相比,高SES(≥9分)人群高血压发病风险下降29.9%(HR=0.701, 95% CI: 0.584~0.842);与≤2种健康生活方式的人群相比,4种、≥5种健康生活方式人群发病风险分别降低25.7%(HR=0.743, 95% CI: 0.581~0.950)、39.2%(HR=0.608, 95% CI: 0.455~0.812)。与SES低且健康生活方式≤2种的人群相比,SES低且具有3种、4种、≥5种健康生活方式人群高血压发病风险的差异均无统计学意义(均有P＞0.05);SES高且具有3种、4种、≥5种健康生活方式的人群高血压发病风险分别降低36.3%(HR=0.637, 95% CI: 0.446~0.909)、44.0%(HR=0.560, 95% CI: 0.391~0.802)、55.8%(HR=0.442, 95% CI: 0.295~0.662)。结论  SES较低人群是贵州省高血压防控的重点人群,应采取措施提高其SES,并有针对性地开展健康教育与健康促进工作。     

社会经济地位与老年人身心健康:兼论社会交往的中介效应

目的:实证分析社会经济地位与我国老年人身心健康的关系.方法:运用多重线性回归、Sobel检验和Bootstrap检验,分析社会经济地位对老年人身心健康的影响及社会交往的中介效应.结果:社会经济地位对老年人身心健康具有显著正向影响,阶层认同、家庭经济状况和受教育年限每增加1分,老年人自评健康分别增加0.096分、0.22...     

城镇化、社会经济地位与居民健康差距

利用1991—2015年“中国健康与营养调查”数据,实证考察城镇化、社会经济地位与居民健康差距之间的关系。研究发现：(1)城镇化影响居民健康。城镇化会显著增加居民的四周患病率,与慢性病患病率和患病数量存在先降后增的关系。(2)城镇化扩大了不同社会经济地位居民之间的健康差距,城镇化对社会经济地位较低居民健康的负面影响更大。(3)机制分析表明,城镇化主要通过生活方式改变、心理压力增大以及肥胖等渠道影响居民的健康状况。因此,在推进新型城镇化和实施“健康中国”战略的背景下,应关注城镇化所带来的健康分配效应,警惕城镇化进程中可能出现的“健康陷阱”。     

河南省老年人社会经济地位对精神健康的影响研究——以医疗保险和居住安排为中介变量

目的 分析河南省老年人社会经济地位与精神健康的关系.方法 使用多阶段分层整群抽样方法,以河南省18个省辖市的5 570名60岁及以上老年人为研究对象,采用有序logistic回归模型分析社会经济地位对老年人精神健康的影响,探讨医疗保险和居住安排的中介效应.结果 河南省老年人精神健康受损1 999人,受损率35.89％....     

不同社会经济地位老年人健康期望寿命研究

目的:研究苏州市社会经济地位(SES)对不同性别老年人健康期望寿命(ALE)占期望寿命(LE)比重的影响.方法:采用分层随机整群抽样的方法.抽取苏州市8个社区共4458名老年人进行日常生活活动能力(ADL)测量.选取SES三个最常用指标收入、教育、职业按两分法分组,探讨不同性别老年人ALE/LE的差异.结果:女性LE高于男性,但ALE随龄递减率快于男性,ALE/LE普遍低于男性;SES高的人群其ALE/LE占优势,但不同SES指标对不同性别人口ALE占余寿比重的影响不同;SES水平不同的人群其ALE/LE的差值随年龄发生变化且呈现性别差异.结论:应加强对SES低水平老年人健康状况的关注,尤其是高龄女性健康,在制定相关政策时考虑性别差异.     

生活方式和心理行为对心血管疾病的影响及对策

心血管疾病的发生和发展除了遗传因素和生物因素外,还与个人的生活方式和心理行为密切相关.国内已有19个点的调查结果显示:在心血管疾病的死因分析中,生活方式和心理行为因素已超过传统的生物因素(45.70比29.00)成为与死亡相关的首位因素[1].     

家庭社会经济地位对青少年主观幸福感影响的多重中介效应分析

目的:探讨家庭社会经济地位与青少年主观幸福感的关系及领悟社会支持和积极心理资本的中介作用。方法:采用家庭社会经济地位问卷、幸福感指数量表、领悟社会支持量表和积极心理资本问卷调查了932名青少年。结果:(1)家庭社会经济地位、领悟社会支持、积极心理资本和主观幸福感两两之间相关显著;(2)家庭社会经济地位对主观幸福感的直接效应不显著,但领悟社会支持、积极心理资本在家庭社会经济地位与主观幸福感之间的三条中介路径均显著。结论:为提升低家庭社会经济地位青少年主观幸福感,改善其领悟社会支持和积极心理资本水平是可实现的有效路径。     

生活方式在社会经济状况与老年人认知功能间的中介效应分析

目的 探讨65岁及以上老年人社会经济状况(socioeconomic status,SES)、生活方式和认知功能三者之间的关系。方法 两阶段整群抽样法抽取湖北省城市社区和农村乡镇65岁及以上老年人,采用半结构化问卷获得其SES、生活方式等信息,简易精神状态量表(mini - mental state examination, MMSE)评估其认知功能;采用逐步回归法分析生活方式在SES与老年认知功能间的中介效应,并进一步应用PROCESS程序进行Bootstrap法中介变量验证。结果 本研究老年人于2019年完成了全套评估,MMSE得分为28（24,30）,SES指数得分为 - 0.36（ - 1.15,1.22）,生活方式指数得分为3（2,4）。相关性分析结果显示,MMSE评分与SES指数呈正相关（rs = 0.640,P＜0.001）,与生活方式指数呈正相关（rs = 0.449,P＜0.001）,SES指数与生活方式指数呈正相关（rs = 0.543,P＜0.001）。中介效应分析结果显示,生活方式在SES与认知功能之间起部分中介作用,中介效应值为0.141（0.097～0.190）,占总效应的10.10%。结论 本研究老年人总体认知功能良好,其SES、生活方式均处于中等水平,生活方式在SES与认知功能之间起部分中介作用。建议相关部门改善居民生活水平,倡导健康生活方式,加强认知干预,以防止认知功能非正常老化。     

社会经济地位生活方式与男性冠心病发病的相关性分析

[目的]探讨社会经济地位与生活方式与冠心病发病的关系.[方法]采用病例对照研究对2009年1月～2010年3月来某院就诊的212例冠心病患者和300例健康对照组的生活习惯及社会经济地位进行了调查分析,所有研究对象均为男性.[结果]经过多因素非条件性Logistic回归分析发现单身或者丧偶,租房住,吸烟与冠心病发病有关.[结论]单身或者丧偶,租房住,吸烟的男性容易发生冠心病.     

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。     

社会经济特征、社会支持对城市社区老年人死亡态度的影响研究Symbol`@@

目的 分析城市社区老年人死亡态度的现状及其与社会经济特征、社会支持的关系,为社区老年人死亡教育干预工作提供依据。方法 采用两阶段随机抽样抽取成都市990名老年人进行调查,应用结构方程模型探讨社会经济特征、社会支持对社区老年人死亡态度的影响及作用路径。结果 67.58%的老年人对死亡持接受态度;在老年男女性的路径中,老年男性的家庭人均月收入（P=0.007,β=0.119）和原职业(PSymbol|@@0.001,β=0.180)对死亡态度有直接作用,而文化程度（P<0.001,β=0.127）对死亡态度产生间接作用;老年女性的原职业对死亡态度同时有直接效应（P=0.018,β=0.101）和间接效应（P=0.001,β=0.007）,其中家庭人均月收入（P=0.001,β=0.039）和文化程度(PSymbol|@@0.001,β=0.094)对死亡态度仅有间接作用。社会支持对不同性别老年人的死亡态度均有直接影响和中介作用。结论 城市社区大部分老年人的死亡态度较积极;社会经济特征、社会支持与其死亡态度相关且存在性别差异,提示社区死亡教育干预应重点关注社会经济特征、社会支持因素对老年人死亡态度的影响。     

Interrelationships between nutritional status, socioeconomic factors, and lifestyle in Indian cataract patients

Objectives

The etiology of cataracts in the Asian subcontinent is not well understood. The aim of this study was to understand the differences in nutritional and lifestyle-related etiology of cataract in a high-income group (HIG) and a low-income group (LIG).

Research methods

A cross-sectional survey was conducted on 140 cataract patients, aged 50-70 y, and 100 age- and sex-matched healthy controls. Socioeconomic information and habitual dietary intake were recorded by interview method. Cataract grading was given by ophthalmologists using a slit-lamp biomicroscope.

Results

In HIG patients, there was a delay of 10 y in the onset of cataracts as compared to LIG patients. Sixty-seven percent of LIG patients were alcoholic and 80% had a family history of cataracts. Further, among LIG male patients, 45%-87% were uneducated and 80% were addicted to tobacco. The intake of animal foods and fried foods was significantly higher in all the patient groups than controls (P < 0.001). The intake of vegetables, fruits, salads, and tea were higher in all the controls than patients (P < 0.001). For HIG male patients, between alcoholics and non-alcoholics, significant differences were noted for antioxidant status and soluble to total proteins ratio of lens. Similar differences were seen between HIG male smokers and non-smokers. Multiple regression analysis of solubility and opacity of lens indicated influence of family size, sunlight exposure, and systolic blood pressure for predisposition of cataracts.

Conclusions

Along with high systolic blood pressure, waist:hip ratio, family size, sunlight exposure, and increased consumption of tobacco and alcohol were the risk factors for cataracts.     

我国公共卫生服务均等化研究现状

公共卫生服务均等化已被我国列入医疗改革的执行内容和近期重点实施的方案中,而国内理论界对它的研究也持续升温。本文从公共卫生服务的相关概念和内涵、公共卫生服务均等化的评价、针对评价结果提出的政策建议等方面总结了我国近年来对于公共卫生服务均等化的研究进展,发现国内学者更关注公共卫生服务的公益性,强调政府在均等化过程中的作用,均等化的评价已初具体系,但我国城乡间和区域间的公共卫生服务尚未完全达到均等化。本文认为国内研究在公共卫生服务相关定义的明确、均等化评价指标和体系的建立以及均等化政策改进等方面存在一定问题,后续研究应以此为重点关注领域。     

The relative contributions of race/ethnicity, socioeconomic status, health, and social relationships to life satisfaction in the United States

Purpose  To evaluate racial/ethnic disparities in life satisfaction and the relative contributions of socioeconomic status (SES; education, income, employment status, wealth), health, and social relationships (social ties, emotional support) to well-being within and across racial/ethnic groups. Methods  In two cross-sectional, representative samples of U.S. adults (the 2001 National Health Interview Survey and the 2007 Behavioral Risk Factor Surveillance System; combined n > 350,000), we compared life satisfaction across Whites, Hispanics, and Blacks. We also evaluated the extent to which SES, health, and social relationships ‘explained’ racial/ethnic group differences and compared the magnitude of variation explained by life satisfaction determinants across and within these groups. Results  Relative to Whites, both Blacks and Hispanics were less likely to be very satisfied. Blacks were somewhat more likely to report being dissatisfied. These differences were reduced or eliminated with adjustment for SES, health, and social relationships. Together, SES and health explained 12–15% of the variation in life satisfaction, whereas social relationships explained an additional 10–12% of the variance. Conclusions  Racial/ethnic life satisfaction disparities exist for Blacks and Hispanics, and these differences are largest when comparing those reporting being ‘satisfied’ to ‘very satisfied’ versus ‘dissatisfied’ to ‘satisfied.’ SES, health, and social relationships were consistently associated with life satisfaction, with emotional support having the strongest association with life satisfaction.     

The role of social support and integration for understanding socioeconomic disparities in self-rated health and hypertension

This paper examines socioeconomic (socioeconomic status, SES) disparities in self-rated health and hypertension among 29,816 US adults aged 25 and older using data from the 2001 wave of the National Health Interview Survey. Our purpose is to examine how influential measures of social support and social integration are for each health outcome, and whether support and integration operate by mediating, or buffering, the effects of SES on health. Multivariate regression models show no significant influence of emotional support, but do indicate that many aspects of social integration are directly associated with self-rated health and hypertension, although these measures do not mediate the relationship between SES and health. However, interaction tests show substantial evidence that measures of social integration buffer some of the negative effects of low SES, particularly the negative influence of not working on self-rated health. In addition, findings indicate potential evidence of help-seeking behavior among adults who did not finish high school or who report financial barriers to medical care. Overall, our findings suggest that social programs designed to foster social integration (e.g., free or low-cost bus fare to promote visits with friends and family) may improve health among persons with low levels of education, who are not working, or who have problems accessing medical care because of financial problems.     

Effects of health literacy on health status and health service utilization amongst the elderly

Amid increased concerns about the adverse consequences of low health literacy, it remains unclear how health literacy affects health status and health service utilization. With a sample of 489 elderly Medicare patients in a Midwestern city in the USA, we explored the intermediate factors that may link health literacy to health status and utilization of health services such as hospitalization and emergency care. We expected to find that individuals with higher health literacy would have better health status and less frequent use of emergency room and hospital services due to (1) greater disease knowledge, (2) healthier behaviors, (3) greater use of preventive care, and (4) a higher degree of compliance with medication. Using path analysis, we found, however, that health literacy had direct effects on health outcomes and that none of these variables of interest was a significant intermediate factor through which health literacy affected use of hospital services. Our findings suggest that improving health literacy may be an effective strategy to improve health status and to reduce the use of expensive hospital and emergency room services among elderly patients.     

The contribution of lifestyle factors to socioeconomic differences in obesity in men and women – a population-based study in Sweden

Background: The objective was to investigate whether and to what extent the association between socioeconomic status and obesity can be explained by lifestyle factors. Methods: The relationship between socioeconomic status (SES) and obesity, and the role of lifestyle factors such as smoking, physical activity, heavy alcohol use, avoidance of dietary fat and propensity to eat fiber-rich food, was studied in a cross-sectional population-based study consisting of 6394 men and women aged 25–74 years in Värmland County in Sweden. Educational level was used for measuring SES. The contribution of the measured lifestyle factors was assessed using logistic regression models. Results: 12% of men and 14% of women were obese. Subjects with high education were leaner than subjects with low education, except among elderly women (65–74 years). Although many lifestyle factors were related to obesity and SES in this study, only a part (18–29%) of the association between educational level and obesity could be explained by the measured lifestyle factors. Physical inactivity and heavy alcohol use were the main factors contributing to this association, whereas smoking and the measured dietary attitudes towards fat and fiber had little additional effect. Conclusions: The findings of this study are consistent with the view that socioeconomic differences in obesity and its consequences can only partly be reduced by changes in lifestyle. Longitudinal studies, a more detailed investigation of the role of dietary factors and more studies including elderly subjects are, however, recommended to further elucidate the association between SES and obesity.