社会经济地位、生活方式与健康不平等

Socioeconomic Status,Lifestyle and Health Inequality

以往研究多认为社会经济地位是人们健康水平最重要的决定因素,但对其影响机制却缺乏理论解释和检验。而社会流行病学研究关注与健康相关的生活方式及行为因素对人们健康水平的影响,但忽视了社会结构因素对人们生活方式的型塑作用。本研究根据健康生活方式模型将生活方式作为社会经济地位影响健康水平的中间机制,通过"中国综合社会调查(2005)"数据,分析中国民众健康不平等的形成过程。研究发现,同欧美主要发达国家一样,中国民众也存在明显的健康不平等,社会经济地位越高的人,其健康水平越高。社会经济地位主要通过健康生活方式影响人们的健康水平,其影响机制可以描述为,社会经济地位越高的人越倾向于拥有和维护健康生活方式,而健康生活方式又直接影响了人们的健康水平。

Many studies on health inequality in main European countries and America have found that socioeconomic status（SES） has powerful and sustainable positive relationships with health.Social causation theory has thus been forwarded,stating that SES is the most important determining factor of one＇s health,namely,those who have higher SES also have better health.However,its mechanism has not been theoretically explained or tested.On the other hand,socialepidemiology has focused on how health-related lifestyle and behavioral factors affect health,but it has neglected the fact that lifestyle isshaped by social structural factors.According to Cockerham＇s lifestyle model,the present research treated lifestyle as the mediating mechanism between SES and health in the analysis of the emergence of the health inequality among Chinese citizens.Three hypotheses were developed：first,there existed health inequality among people with different socioeconomic statuses in China;second,health-related lifestyle would have a significant effect on health;and third,SES influenced health via lifestyle.All three hypotheses were supported by the data from China General Social Survey（2005）.As those developed countries in Europe and America,China apparently had significant health inequality among people：the higher the SES,the better the health status（measured by self-reported method）.SES influenced health via health-related lifestyle by the healthy-lifestyle-demand mechanism.The groups in higher social statues demanded much more for healthy lifestyle and they were able to afford the expenses to maintain such lifestyle,which in turn directly promoted their health.