Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Khám Phá Các Mối Quan Hệ Phức Tạp Giữa Các Quy Determinants Xã Hội Của Sức Khỏe Tại Andalusia Sau Cuộc Khủng Hoảng Tài Chính Năm 2008
Tóm tắt
Trong nghiên cứu này, chúng tôi phân tích mối quan hệ phức tạp giữa các yếu tố xã hội cấu trúc và trung gian ảnh hưởng đến sức khỏe tại Andalusia (Tây Ban Nha) sau giai đoạn suy thoái kinh tế, với mục tiêu hiểu rõ các yếu tố có thể được giải quyết nhằm giảm thiểu bất bình đẳng sức khỏe trong các vùng có nguy cơ kinh tế xã hội. Dữ liệu từ dự án IMPACT-A đã được sử dụng. Mẫu nghiên cứu của chúng tôi bao gồm 1200 cá nhân được chọn ngẫu nhiên theo quy trình lấy mẫu phân tầng dựa trên giới tính, nhóm tuổi và tám tỉnh tại Andalusia (Tây Ban Nha). Phương pháp mô hình phương trình cấu trúc đã được áp dụng để kiểm tra độ phù hợp của dữ liệu với nền tảng lý thuyết trước đó. Kết quả của chúng tôi cho thấy rằng các yếu tố kinh tế - xã hội và nhân khẩu học có mối liên hệ với sức khỏe thông qua việc ảnh hưởng đến lối sống, trải nghiệm kinh tế xã hội trong thời kỳ khủng hoảng và sự an lạc cá nhân. Thêm vào đó, một số đóng góp đáng chú ý từ kết quả có thể được nêu bật: (a) sự khác biệt quan trọng trong kết quả sức khỏe được phát hiện ở phụ nữ Andalusia, (b) không có mối liên hệ giữa thu nhập và lối sống, (c) những người có nhu cầu y tế chưa được đáp ứng thể hiện sự cảm nhận cao hơn về sự phân biệt xã hội, và (d) sự phân biệt và hạnh phúc có tác động trung gian đến sức khỏe. Mô hình cuối cùng giải thích hơn một phần ba phương sai trong sức khỏe và mô tả mối liên kết phức tạp của các yếu tố xã hội cần được giải quyết để giảm thiểu bất bình đẳng về sức khỏe trong khu vực này.
Từ khóa
#Sức khỏe #yếu tố xã hội #bất bình đẳng sức khỏe #Andalusia #khủng hoảng tài chính #mô hình phương trình cấu trúcTài liệu tham khảo
Adams, P., Hurd, M. D., McFadden, D., Merrill, A., & Ribeiro, T. (2003). Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status. Journal of Econometrics, 112(1), 3–56. https://doi.org/10.1016/S0304-4076(02)00145-8.
Adler, N. E., & Newman, K. (2002). Socioeconomic disparities in health: pathways and policies. Health Affairs (Project Hope), 21(2), 60–76.
Allen, J., Balfour, R., Bell, R., & Marmot, M. (2014). Social determinants of mental health. International Review of Psychiatry, 26(4), 392–407. https://doi.org/10.3109/09540261.2014.928270.
Alvarez-Galvez, J. (2016). Discovering complex interrelationships between socioeconomic status and health in Europe: A case study applying Bayesian Networks. Social Science Research, 56, 133–143. https://doi.org/10.1016/j.ssresearch.2015.12.011.
Alvarez-Galvez, J., & Gomez-Baya, D. (2017). Socioeconomic context as a moderator in the relationship between body mass index and depression in Europe. Applied Psychology: Health and Well-Being, 9(3), 410–428.
Alvarez-Galvez, J., Rodero-Cosano, M. L., García-Alonso, C., & Salvador-Carulla, L. (2014). Changes in socioeconomic determinants of health: comparing the effect of social and economic indicators through European welfare state regimes. Journal of Public Health, 22(4), 305–311. https://doi.org/10.1007/s10389-014-0623-x.
Alvarez-Galvez, J., Rodero-Cosano, M. L., Motrico, E., Salinas-Perez, J. A., Garcia-Alonso, C., & Salvador-Carulla, L. (2013). The impact of socio-economic status on self-rated health: Study of 29 countries using European social surveys (2002–2008). International Journal of Environmental Research and Public Health, 10(3), 747–761. https://doi.org/10.3390/ijerph10030747.
Alvarez-Galvez, J., & Salvador-Carulla, L. (2013). Perceived discrimination and self-rated health in Europe: evidence from the European Social Survey (2010). PLoS ONE, 8(9), e74252. https://doi.org/10.1371/journal.pone.0074252.
An, R. (2015). Educational disparity in obesity among U.S. adults, 1984–2013. Annals of Epidemiology, 25(9), 637–642. https://doi.org/10.1016/j.annepidem.2015.06.004.
Arbuckle, J. (2003). Amos 5.0 update to the Amos user’s guide. Chicago: Marketing Department, SPSS Inc.
Bambra, C., Netuveli, G., & Eikemo, T. A. (2010). Welfare state regime life courses: The development of western European welfare state regimes and age-related patterns of educational inequalities in self-reported health. International Journal of Health Services: Planning, Administration, Evaluation, 40(3), 399–420.
Bambra, C., Pope, D., Swami, V., Stanistreet, D., Roskam, A., Kunst, A., et al. (2009). Gender, health inequalities and welfare state regimes: A cross-national study of 13 European countries. Journal of Epidemiology and Community Health, 63(1), 38–44. https://doi.org/10.1136/jech.2007.070292.
Bartley, M., Sacker, A., & Clarke, P. (2004). Employment status, employment conditions, and limiting illness: Prospective evidence from the British household panel survey 1991–2001. Journal of Epidemiology and Community Health, 58(6), 501–506.
Batista-Foguet, J. M., & Coenders, G. (2000). Modelos de Ecuaciones Estructurales. Madrid: La Muralla.
Blodorn, A., Major, B., & Kaiser, C. (2016). Perceived discrimination and poor health: Accounting for self-blame complicates a well-established relationship. Social Science and Medicine, 153, 27–34.
Borrell, C., Rodríguez-Sanz, M., Bartoll, X., Malmusi, D., & Novoa, A. M. (2014). El sufrimiento de la población en la crisis económica del Estado español. Salud Colectiva, 10(1), 95–98.
Cervero-Liceras, F., McKee, M., & Legido-Quigley, H. (2015). The effects of the financial crisis and austerity measures on the Spanish health care system: A qualitative analysis of health professionals’ perceptions in the region of Valencia. Health Policy, 119(1), 100–106. https://doi.org/10.1016/j.healthpol.2014.11.003.
Comisión para Reducir las Desigualdades Sociales en Salud en España. (2012). Propuesta de políticas e intervenciones para reducir las desigualdades sociales en salud en España. Gaceta Sanitaria, 26(2), 182–189.
Córdoba-Doña, J. A., Escolar-Pujolar, A., San Sebastián, M., & Gustafsson, P. E. (2016). How are the employed and unemployed affected by the economic crisis in Spain? Educational inequalities, life conditions and mental health in a context of high unemployment. BMC Public Health, 16(1), 267.
Dahl, E., & van der Wel, K. (2013). Educational inequalities in health in European welfare states: a social expenditure approach. Social Science and Medicine, 81, 60–69.
Duncan, O. D. (1966). Path analysis: Sociological examples. American Journal of Sociology, 72(1), 1–16.
Evans, G. W., & Kantrowitz, E. (2002). Socioeconomic status and health: The potential role of environmental risk exposure. Annual Review of Public Health, 23(1), 303–331.
Frijters, P., Haisken-DeNew, J. P., & Shields, M. A. (2005). The causal effect of income on health: Evidence from German reunification. Journal of Health Economics, 24(5), 997–1017. https://doi.org/10.1016/j.jhealeco.2005.01.004.
Gallo, P., & Gene-Badia, J. (2013). Cuts drive health system reforms in Spain. Health Policy, 113(1–2), 1–7. https://doi.org/10.1016/j.healthpol.2013.06.016.
Gandek, B., Ware, J. E., Aaronson, N. K., Apolone, G., Bjorner, J. B., Brazier, J. E., et al. (1998). Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: Results from the IQOLA project. Journal of Clinical Epidemiology, 51(11), 1171–1178.
García Calvente, M. M., Del Río Lozano, M., Marcos Marcos, J., Maroto Navarro, G., Ocaña Riola, R., Sánchez Villegas, P., et al. (2015). Atlas de desigualdades de género en salud en Andalucía (10th ed.). Granada: Escuela andaluza de Salud Pública.
Gee, G. C., & Payne-Sturges, D. C. (2004). Environmental health disparities: A framework integrating psychosocial and environmental concepts. Environmental Health Perspectives, 112(17), 1645–1653.
Glonti, K., Gordeev, V. S., Goryakin, Y., Reeves, A., Stuckler, D., McKee, M., et al. (2015). A systematic review on health resilience to economic crises. PLoS ONE, 10(4), e0123117. https://doi.org/10.1371/journal.pone.0123117.
Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2006). Multivariate data analysis (6th ed.). New Jersey: Pearson Prentice Hall.
Heras-Mosteiro, J., Legido-Quigley, H., Sanz-Barbero, B., & Otero-Garcia, L. (2016). Health care austerity measures in times of crisis: The perspectives of primary health care physicians in Madrid, Spain. International Journal of Health Services: Planning, Administration, Evaluation, 46(2), 283–299. https://doi.org/10.1177/0020731415625251.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118.
Kim, S. S., & Williams, D. R. (2012). Perceived discrimination and self-rated health in South Korea: A nationally representative survey. PLoS ONE, 7(1), e30501. https://doi.org/10.1371/journal.pone.0030501.
Kline, R. B. (2004). Principles and practice of structural equation modeling. New York: Guilford.
Lawrence, E. M., Rogers, R. G., & Wadsworth, T. (2015). Happiness and longevity in the United States. Social Science and Medicine, 1982(145), 115–119. https://doi.org/10.1016/j.socscimed.2015.09.020.
Leech, R. M., McNaughton, S. A., & Timperio, A. (2014). The clustering of diet, physical activity and sedentary behavior in children and adolescents: A review. The International Journal of Behavioral Nutrition and Physical Activity, 11, 4. https://doi.org/10.1186/1479-5868-11-4.
Li, C. C. (1975). Path analysis-a primer. Pacific Grove: The Boxwood Press.
Lopez-Casasnovas, G., & Soley-Bori, M. (2014). The socioeconomic determinants of health: Economic growth and health in the OECD countries during the last three decades. International Journal of Environmental Research and Public Health, 11(1), 815–829. https://doi.org/10.3390/ijerph110100815.
Mackenbach, J. P. (2012). The persistence of health inequalities in modern welfare states: The explanation of a paradox. Social Science and Medicine, 75(4), 761–769. https://doi.org/10.1016/j.socscimed.2012.02.031.
Malmusi, D., Vives, A., Benach, J., & Borrell, C. (2014). Gender inequalities in health: Exploring the contribution of living conditions in the intersection of social class. Global Health Action, 7, 23189. https://doi.org/10.3402/gha.v7.23189.
Mansfield, L., Anokye, N., Fox-Rushby, J., & Kay, T. (2015). The Health and Sport Engagement (HASE) intervention and evaluation project: Protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity. British Medical Journal Open, 5(10), e009276. https://doi.org/10.1136/bmjopen-2015-009276.
Marmot, M., & Allen, J. J. (2014). Social determinants of health equity. American Journal of Public Health, 104(S4), S517–S519. https://doi.org/10.2105/AJPH.2014.302200.
Marmot, M., Fuhrer, R., Ettner, S. L., Marks, N. F., Bumpass, L. L., & Ryff, C. D. (1998). Contribution of psychosocial factors to socioeconomic differences in health. The Milbank Quarterly, 76(3), 403–448.
Neumann, Y. (1978). Assessing causality in organizational studies: The path-analytic approach. The Academy of Management Review, 3(2), 366–369. https://doi.org/10.2307/257677.
Nummela, O. P., Sulander, T. T., Heinonen, H. S., & Uutela, A. K. (2007). Self-rated health and indicators of SES among the ageing in three types of communities. Scandinavian Journal of Public Health, 35(1), 39–47. https://doi.org/10.1080/14034940600813206.
Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic disparities in health behaviors. Annual Review of Sociology, 36, 349–370. https://doi.org/10.1146/annurev.soc.012809.102529.
Shipley, B. (2016). Cause and correlation in biology: A user’s guide to path analysis, structutal equations and causal inference with R. Cambridge: Cambridge University Press.
Singh, G. K., Siahpush, M., Hiatt, R. A., & Timsina, L. R. (2011). Dramatic increases in obesity and overweight prevalence and body mass index among ethnic-immigrant and social class groups in the United States, 1976–2008. Journal of Community Health, 36(1), 94–110. https://doi.org/10.1007/s10900-010-9287-9.
Suess, A., Ruiz-Azarola, A., Tamayo-Velázquez, M., García-Toyos, N., López-Doblas, M., & Luque-Martin, N., et al. (2015). Mortgage-related eviction processes, self-reported health status, experiences of discrimination and civil society engagement: Analysis from a social determinants of health frameworkamets suess. European Journal of Public Health, 25(suppl_3).
Ware, J. E., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.
Wilkinson, R. G. (1997). Socioeconomic determinants of health. Health inequalities: relative or absolute material standards? BMJ, 314(7080), 591–595.
Wilkinson, R. G., & Marmot, M. (Eds.). (2003). Social determinants of health: The solid facts. World Health Organization.
Wilkinson, R. G., & Pickett, K. E. (2006). Income inequality and population health: a review and explanation of the evidence. Social Science and Medicine, 62(7), 1768–1784. https://doi.org/10.1016/j.socscimed.2005.08.036.
World Health Organization. (2010). A conceptual framework for action on the social determinants of health. Geneva: WHO press.
Zaninotto, P., Head, J., Stamatakis, E., Wardle, H., & Mindell, J. (2009). Trends in obesity among adults in England from 1993 to 2004 by age and social class and projections of prevalence to 2012. Journal of Epidemiology and Community Health, 63(2), 140–146. https://doi.org/10.1136/jech.2008.077305.