Socioeconomic inequalities in the health of children and adolescents. A comparative study of the five Nordic countries
作者:M Halldorsson
DOI:10.1093/eurpub/10.4.281
日期:2000.12.1
Background: Socioeconomic differences in health among adults exist in the Nordic countries as well as in all other countries where this has been examined. The present study examines whether such differences can also be found among children and adolescents, whether these differences vary between the Nordic countries and whether they can be found in all age groups of children and adolescents. Methods: Questionnaires on health, well-being and socioeconomic status (SES) were sent to parents of a random sample of children aged 2–17 years, equally distributed between Denmark, Finland, Iceland, Norway and Sweden. The indicators of reported ill health were having one or more chronic diseases, frequent moderate or severe symptoms and short stature. The socioeconomic variables were education and occupation of both parents and disposable family income. Logistic regression analysis was used to measure the association between health and SES. Results: Parents in lower socioeconomic groups in all countries reported more ill health for their children at all ages and their children more often belonged to the lowest decile in reported height. Sweden and Denmark on the whole showed larger inequalities than the other three countries, but the difference between countries was small and varied according to the indicators of ill health used. The size of the reported health inequalities did not vary with age: the differences were as marked among adolescents as among younger children. Conclusions: Substantial inequalities in health according to SES can be found in childhood and adolescence, even in well-developed welfare states.
背景:北欧国家以及所有其他对此进行研究的国家都存在成年人健康方面的社会经济差异。本研究探讨了这种差异是否也存在于儿童和青少年中,这些差异在北欧国家之间是否存在差异,以及这些差异是否存在于所有年龄段的儿童和青少年中。方法:向 2-17 岁儿童的随机样本的父母发送有关健康、福祉和社会经济地位 (SES) 的调查问卷,这些调查问卷均匀分布在丹麦、芬兰、冰岛、挪威和瑞典。报告的健康状况不佳的指标是患有一种或多种慢性疾病、频繁出现中度或重度症状以及身材矮小。社会经济变量是父母双方的教育和职业以及可支配家庭收入。逻辑回归分析用于衡量健康与社会经济地位之间的关联。结果:所有国家中社会经济地位较低群体的父母都报告说,他们的孩子在各个年龄段的健康状况都更差,而且他们的孩子往往属于报告身高最低的十分之一。总体而言,瑞典和丹麦比其他三个国家表现出更大的不平等,但国家之间的差异很小,并且根据所使用的不良健康指标而有所不同。所报告的健康不平等的程度并不随年龄的变化而变化:这种差异在青少年中与年幼的儿童中一样明显。结论:根据社会经济地位,即使在发达的福利国家,在儿童和青少年时期也可以发现健康方面的严重不平等。