社会流动有助于降低健康不平等吗？

Does Social Mobility Contribute to Reduce the Inequality of Health?

关于健康不平等现象主要存在两种理论解释,即社会因果论和健康选择论。以往研究主要通过追踪数据来检验两种理论的基本观点。本研究运用中国综合社会调查数据(CGSS2005),从社会流动的角度分析中国民众的健康不平等状况及其产生机制,并从侧面比较了这两种理论的解释力。本研究强调健康不平等是社会阶层地位不平等的再生产,而社会流动是降低社会阶层地位不平等的重要途径。因而,本研究假设,是否发生社会流动对于改变人们的健康水平具有重要影响,社会上向(下向)流动能够促进(降低)人们的健康水平,并且有助于降低不同社会阶层之间的健康梯度。分析发现,社会流动(方向和距离)对人们的健康水平有显著作用,但只有长距离的社会流动才对人们的健康水平有明显的提升(或抑制)作用。从总体上看,在当前中国背景下,社会因果论的解释力强于健康选择论。社会流动在健康不平等的产生过程中,起到了一定的"混合"作用,有助于降低健康不平等水平。

There are two main theoretical points of view for explaining health inequalities,i. e. ,social causation explanation and health selective theory. The former emphasizes that social structural factors have determinative effects on health inequalities;however,the latter considers that whether people are healthful would be a screen mechanism for them to move up or down. In past researches,many use longitudinal data to test these two points,while the present research uses Chinese General Social Survey (2005) to analyze the inequality of health status and explain it from the perspective of social mobility for lack of ideal data. This research agrees that the health inequality is the reproduction of social inequality,and social mobility was thought to be an important way to reduce the social inequality. So we develop two basic hypotheses for the relationship between social mobility and health inequalities. The first one is whether people happened to have social mobility would change their health level,and upward mobility would promote their health status,instead for the opposite. The second one is that social mobility can reduce the health gradient of different stratum. The analysis finds that,the directions and steps of social mobility have significant influence on peoples’level of health,but only long steps of social mobility can promote or restrain works. Generally speaking,in the current background of China,the social causation theory has more power than health selective theory for explaining the health inequality. Social mobility has mixed effect in the production process of health inequalities and reduces it.