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首页> 外文期刊>International journal for equity in health >The wider determinants of inequalities in health: a decomposition analysis
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The wider determinants of inequalities in health: a decomposition analysis

机译：健康不平等的更广泛决定因素：分解分析

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Background The common starting point of many studies scrutinizing the factors underlying health inequalities is that material, cultural-behavioural, and psycho-social factors affect the distribution of health systematically through income, education, occupation, wealth or similar indicators of socioeconomic structure. However, little is known regarding if and to what extent these factors can assert systematic influence on the distribution of health of a population independent of the effects channelled through income, education, or wealth. Methods Using representative data from the German Socioeconomic Panel, we apply Fields' regression based decomposition techniques to decompose variations in health into its sources. Controlling for income, education, occupation, and wealth, we assess the relative importance of the explanatory factors over and above their effect on the variation in health channelled through the commonly applied measures of socioeconomic status. Results The analysis suggests that three main factors persistently contribute to variance in health: the capability score, cultural-behavioural variables and to a lower extent, the materialist approach. Of the three, the capability score illustrates the explanatory power of interaction and compound effects as it captures the individual's socioeconomic, social, and psychological resources in relation to his/her exposure to life challenges. Conclusion Models that take a reductionist perspective and do not allow for the possibility that health inequalities are generated by factors over and above their effect on the variation in health channelled through one of the socioeconomic measures are underspecified and may fail to capture the determinants of health inequalities.
机译：背景许多研究健康不平等的潜在因素的研究的共同出发点是，物质，文化-行为和心理-社会因素通过收入，教育，职业，财富或类似的社会经济结构指标系统地影响健康的分布。但是，关于这些因素是否以及在多大程度上可以断言对人口健康分布的系统性影响鲜为人知，而与收入，教育或财富带来的影响无关。方法我们使用来自德国社会经济专家组的代表性数据，运用菲尔德斯基于回归的分解技术，将健康状况的变化分解为其来源。在控制收入，教育，职业和财富方面，我们评估了解释性因素的相对重要性，这些因素除了通过通常采用的社会经济地位衡量指标对健康变化产生的影响之外，还具有相对重要性。结果分析表明，影响健康差异的三个主要因素持续存在：能力得分，文化行为变量以及在较小程度上是唯物主义方法。在这三个得分中，能力得分说明了互动和复合效应的解释能力，因为它捕获了个人与生活挑战相关的社会经济，社会和心理资源。结论采取还原论观点的模型并没有充分考虑通过不平等因素通过一种社会经济措施对健康变化产生影响的因素所导致的健康不平等的可能性，而这些模型可能无法捕捉健康不平等的决定因素。

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