社会资本在健康领域的应用现状

在解释收入不平等对健康差异的影响作用时，流行病学家引入了社会资本的概念，尽管社会资本理论自身还存在很多争议，但其与健康关系的研究引起了众多学者的兴趣。本文从各种社会资本的概念，社会资本在健康领域研究中的应用，社会资本影响健康的可能机制，各种测量方法和存在的不足以及在中国目前的应用现状等方面进行了浅析。     

山东省农村居民健康的影响因素分析

目的:分析山东省农村居民健康的影响因素,探讨社会资本对健康的影响。方法:抽取山东省章丘、金乡和茌平三县16~80岁在家的农村居民1402人进行问卷调查,运用二项logistic回归分析资料。结果:女性、年龄大、婚姻不和谐、生活满意度低的居民比男性、年龄小、婚姻和谐、生活满意度高的居民健康状况差;同时发现社会资本影响居民健康,主要包括感情支持、社会责任感、社会参与和信任,其中感情支持对居民健康的影响较大。结论:农村居民健康影响因素包括性别、年龄、婚姻、生活满意度、社会资本,其中社会资本促进居民健康。     

农村流动人口社会支持与客观健康、自感健康的关系研究

[目的]探讨农村流动人口社会支持与客观健康、自感健康的关系. [方法]采用社会支持评定量表(SSRS),随机抽取贵阳市522名农村流动人口进行问卷调查. [结果]健康人群的客观支持均分明显高于患病人群(P<0.01).自感健康好者的主客观支持和总分的均分均高于自感健康差者(P<0.01);家人是患病人群和自感健康差者最重要的支持来源,缺乏政府和非政府组织的支持;社会支持和是否遭受城市居民歧视是影响农村流动人口客观健康和自感健康的共同因素(P<0.05).[结论]政府应以城市社会可持续发展和促进农村流动人口顺利融入城市社会为目标,通过相关的公共政策引导,构建完备的社会支持系统,增加对农村流动人口社会支持的扶持力度,最终达到解决其健康问题的目的.     

社会资本对农村户籍老年人健康的影响与性别差异研究

[目的]了解不同类别社会资本(人际信任、社会支持、社会参与)对我国农村户籍老年人健康的影响及性别差异.[方法]基于2017-2018年中国老年健康影响因素跟踪调查(CLHLS)数据对9068名60岁以上农村户籍老年人进行分析.[结果]社会参与(正式和非正式)和人际信任对农村户籍老年人健康状况的积极影响显著,有社会参与的...     

农村居民社会支持现状及相关因素分析

社会支持( social support)是建立在社会网络结构上的各种社会关系对个体的影响力,社会支持的高低是影响居民健康的重要社会因素,良好的社会支持对健康有益,已得到广泛认同[1].国内对各类患者社会支持状况研究较多,而对农村居民社会支持状况的研究较少,故2009年8月对农村居民社会支持状况及相关因素进行研究,旨在探究农村居民社会支持影响因素的关系,为改善农村居民社会支持状况,提高居民健康提供依据.1对象与方法1.1对象采用分层整群随机抽样方法,抽取山东省东营市广饶县、垦利县、利津县3个县作为样本县,在每个县随机抽取3个乡镇,在每个乡镇随机抽取4个村,按照门牌号从每个村随机抽取50户农村居民家庭,对被抽中家庭的年龄≥15岁能独立回答评定量表的农村居民作为研究对象,剔除无效样本后,共收集2 599份有效样本.     

现阶段农民自感健康状况及其影响因素分析

目的了解在现阶段农村经济政策和社会结构变化的影响下．农民的自感健康状况及其影响因素。方法采用入户问卷调查法．对山东省农村1406名16～80岁的农民进行了调查。结果农民的自感健康状况与身体状况相一致，且受心理健康、文化水平、婚姻状况、社会资本和社会支持的影响。建议加强农民的心理健康教育，提高农民的文化素质，鼓励农民参与社会活动。     

山东省农村居民社会资本构成及影响因素分析

[目的]明确农村居民社会资本的构成要素及其影响因素。[方法]运用分层随初抽样方法，抽取山东省章丘、金乡和茌平三县家庭成员1402人进行问卷调查。[结果]社会资本的构成要素为：感情支持、物质支持、邻居信任、对村委的信任、社会责任感、社会交往和社会参与；影响因素为：性别、年龄、文化程度和收入。[结论]农村居民社会资本的构成要素不是人们简单想象的社会交往，分析社会资本对健康的影响时应全面考虑其包含的内容。     

杭州市本专科新生社会资本对健康的影响

了解杭州市本专科新生社会资本现状及其与健康之间关系,为改善本专科新生健康状况提供参考.方法 采用多阶段分层整群随机抽样方法,共调查杭州市3所大学的1 105名新生.利用社会资本调查问卷、自尊量表、生活满意度量表进行调查,采用结构方程模型分析本科和专科新生社会资本对健康的影响.结果 本科新生的社会支持、社会信任、社会归属感、社会网络、社会参与均分(47.95±8.09,17.09±2.47,24.21 ±4.22,10.80±2.55,5.21±14.22)均高于专科新生(46.61±7.71,16.04±2.48,23.28±3.96,7.62± 1.95,4.66± 1.40)(f值分别为6.50,2.56,3.40,22.62,1.14,P值均<0.05).结构方程模型分析显示,本科和专科新生社会资本潜自变量对健康潜因变量的标准化路径系数分别为0.76和0.82,其中社会归属感对本科学生健康的影响最大(r=0.62),社会支持对专科学生健康的影响最大(r=0.70).结论 本科和专科新生社会资本对健康有积极影响.增强本科学生的社会归属感和提高专科学生的社会支持有利于改善身心健康状况.     

社会性别视角下社会资本与农村老年人生命质量的关系研究

目的调查农村老年人健康相关生命质量和社会资本的性别差异,并探讨二者之间的关系。方法2013年4~5月,在山东省三县采用分层整群随机抽样抽取975名60~75岁的农村老年人,利用SF-36量表和"资源生成器"量表,通过问卷调查的方式测量其健康相关生命质量和社会资本的拥有情况,应用广义线性模型分析不同性别老年人生命质量的主要影响因素。结果农村男性老人的生理层面和心理层面的生命质量得分分别为(57.70±28.72)分和(55.93±24.83)分,女性老人的生理层面和心理层面的生命质量得分分别为(43.43±33.00)分和(44.94±28.27)分。总体社会资本与男性和女性老人两个层面的生命质量均呈有统计学意义的正相关关系(P0.01)。广义线性回归分析显示,总体社会资本每提高1分,男性的生理和心理层面的生命质量得分分别提高1.08和0.79分,而女性的生理和心理层面的生命质量得分分别提高2.03和1.76分。结论农村男性老人的生理层面和心理层面的生命质量均优于女性老人,而女性老人能从社会资本中获得更大的健康收益。     

工作场所社会资本与健康关系的探索性研究

目的评价工作场所社会资本量表的信度和效度,分析工作场所社会资本与健康的关系。方法采用整群抽样的方法,对上海市10个单位的员工进行问卷调查。应用克隆巴赫系数(Cronbach’sα)、Guttman分半系数和验证性因子分析评价工作场所社会资本的信度和效度;采用多元线性回归分析工作场所社会资本与健康的关系。结果工作场所社会资本量表的Cronbach’sα系数为0.94,Guttman分半系数为0.92,表明量表具有较好的内部一致性;验证性因子分析结果显示:KMO值为0.91,共提取1个公因子,累计方差贡献率为70.5%,表明量表具有较好的结构效度。在控制其他可能影响健康的因素后,工作场所社会资本与自报健康得分呈负相关(B=-0.112,P<0.01)和身心健康呈正相关(B=1.771,P<0.01)。结论工作场所社会资本量表具有较好的信度和效度,且工作场所社会资本是自评健康和心理健康的重要影响因素。     

健康公平性概述

健康公平性在国际上得到广泛关注,各国把消除健康不公平作为卫生改革与发展的主要目标。本文就健康公平性的内涵进行梳理,为我国健康公平性内涵和测量研究提供参考。     

The Communication Infrastructure as a Social Determinant of Health: Implications for Health Policymaking and Practice

Policy Points

• Persistent communication inequalities limit racial/ethnic minority access to life‐saving health information and make them more vulnerable to the effects of misinformation.
•  Establishing data collection systems that detect and track acute gaps in the supply and/or access of racial/ethnic minority groups to credible health information is long overdue.
• Public investments and support for minority‐serving media and community outlets are needed to close persistent gaps in access to credible health information.

     

Policy Commercializing Nonprofits in Health: The History of a Paradox From the 19th Century to the ACA

Policy Points:

• Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector.
• This policy paradox persists during the implementation of the Affordable Care Act of 2010.

Context

For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization. The implementation of the Affordable Care Act of 2010 (ACA) began yet another chapter in the history of this policy paradox.

Methods

This article explores the origin and persistence of the paradox using what many scholars call “interpretive social science.” This methodology prioritizes history and contingency over formal theory and methods in order to present coherent and plausible narratives of events and explanations for them. These narratives are grounded in documents generated by participants in particular events, as well as conversations with them, observing them in action, and analysis of pertinent secondary sources. The methodology achieves validity and reliability by gathering information from multiple sources and making disciplined judgments about its coherence and correspondence with reality.

Findings

A paradox with deep historical roots persists as a result of consensus about its value for both population health and the revenue of individuals and organizations in the health sector. Participants in this consensus include leaders of governance who have disagreed about many other issues. The paradox persists because of assumptions about the burden of disease and how to address it, as well as about the effects of biomedical science that is translated into professional education, practice, and the organization of services for the prevention, diagnosis, treatment, and management of illness.

Conclusions

The policy paradox that has incentivized the growth and commercialization of nonprofits in the health sector since the late 19th century remains influential in health policy, especially for the allocation of resources. However, aspects of the implementation of the ACA may constrain some of the effects of the paradox.     

The Impact of Medical Home on Selected Children's Health Outcome

Medical Home practice has been shown to deliver effective health care to children. This practice model calls for providing patient-centered care that is compassionate, culturally effective, coordinated, integrated, safe, of high quality, and accessible. This study shows that children in the states with a higher amount of Medical Home received childhood vaccinations at a higher rate than others. However, Medical Home had a limited effect on the rate of children receiving dental/medical services, mental health services, or number of overweight children.     

Understanding population health terminology

Population health is a relatively new term, with no agreement about whether it refers to a concept of health or a field of study of health determinants. There is debate, sometimes heated, about whether population health and public health are identical or different. Discussions of population health involve many terms, such as outcomes, disparities, determinants, and risk factors, which may be used imprecisely, particularly across different disciplines, such as medicine, epidemiology, economics, and sociology. Nonetheless, thinking and communicating clearly about population health concepts are essential for public and private policymakers to improve the population's health and reduce disparities. This article defines and discusses many of the terms and concepts characterizing this emerging field.     

1994年全国学校卫生现状抽样调查──2000年学校卫生发展战略目标与对策研究之一

全国抽样调查561所城乡中小学校的学校卫生现状。结果表明,我国城乡中小学校的学校卫生现状具有两大特点:其一,学校卫生发展呈现出以经济发达地区城市中学领先、经济欠发达地区乡村小学明显滞后的总态势。其二,学校卫生三个维度发展不平衡,健康环境明显落后于健康服务和健康教育。     

Adolescent Health: Priorities for the Next Millennium

There have been dramatic changes in adolescent health status over the past decade that have resulted from successful interventions. Overall mortality rates are down 14%, and many morbidities have declined. Today we know many of the elements that reduce risk: parental caring and connectedness, parental expectations for school and parent availability all outweigh family structure, ethnicity, and income. Likewise, schools can be extremely protective when young people feel connectedness. Factors associated with successful interventions include: strengthening families; strengthening educational involvement; expanding economic opportunities; and supporting youth development, not just problem reduction. Priorities for the next decade include: establishing resiliency-building interventions; developing positive correlates of negative behaviors; establishing broader multisectorial interdisciplinary teams; and formulating a new, more inclusive framework for adolescent health and development.