英国公务员的健康不平等:惠特霍尔II研究
M G Marmot1, G D Smith, S Stansfeld
1Department of Epidemiology and Public Health, University College and Middlesex School of Medicine, London.
Lancet (London, England)
|June 8, 1991
概括
怀特霍尔二号研究发现,公务员中较低的社会阶级与更糟糕的健康状况和更多的疾病有关. 这些健康差异仍然存在,强调需要解决社会和工作环境的问题.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康的社会决定因素
背景情况:
- 怀特霍尔研究 (1967) 确定了社会阶级和死亡率之间的强烈联系.
- 几十年来,健康方面的社会不平等一直存在.
研究的目的:
- 调查发病率的社会梯度的程度和原因.
- 检查公务员职位等级之间的健康差异.
主要方法:
- 一组10314名英国公务员 (年龄在35-55岁之间) 参与了这项研究.
- 通过自我管理的问卷和查检查收集的数据.
- 自最初的怀特霍尔研究以来,随访时间超过20年.
主要成果:
- 在就业等级和心痛,缺血和慢性支气管炎症状的患病率之间发现了反向关联.
- 较低的就业等级报告了更糟糕的自我感知健康和更多的症状.
- 在不同就业级别之间观察到健康行为 (吸烟,饮食,运动),经济和社会情况以及工作环境 (控制,满意度) 的显著差异.
结论:
- 疾病发病率的社会阶级梯度仍然很大.
- 导致这些梯度的因素包括健康行为,社会经济地位,早期生活环境和心理社会工作条件.
- 建议包括促进健康行为,解决社会环境,职位设计和收入不平等问题.
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