【Elsevier】经济、社会资本与健康

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Social determinants of health – A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes

Abstract

Social structures and socioeconomic patterns are the major determinants of population health.

However, very few previous studies have simultaneously analysed the “social” and the “economic” indicators when addressing social determinants of health.

We focus on the relevance of economic and social capital as health determinants by analysing various indicators.

The aim of this paper was to analyse independent associations, and interactions, of lack of economic capital (economic hardships) and social capital (social participation, interpersonal and political/institutional trust) on various health outcomes.

Data was derived from the 2009 Swedish National Survey of Public Health, based on a randomly selected representative sample of 23,153 men and 28,261 women aged 16–84 year, with a participation rate of 53.8%.

Economic hardships were measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves.

Social capital was measured by social participation, interpersonal (horizontal) trust and political (vertical/institutional trust) trust in parliament.

Health outcomes included; (i) self-rated health, (i) psychological distress (GHQ-12) and (iii) musculoskeletal disorders. Results from multivariate logistic regression show that both measures of economic capital and low social capital were significantly associated with poor health status, with only a few exceptions. Significant interactive effects measured as synergy index were observed between economic hardships and all various types of social capital. The synergy indices ranged from 1.4 to 2.3. The present study adds to the evidence that both economic hardships and social capital contribute to a range of different health outcomes. Furthermore, when combined they potentiate the risk of poor health.

习语In  reserve：available to be used in the future or when needed 储备；备用

The money was being kept in reserve for their retirement.他们把钱存着以备退休后使用。

Synergy |ˈsɪnədʒi; 美 -ərdʒi|  [不可数名词, 可数名词] (pl. -ies)

(technical 术语) the extra energy, power, success, etc. that is achieved by two or more people or companies working together, instead of on their own 协同作用，协同增效作用（人或公司共同协作所产生的效果优于各自单独行动的效果）

Highlights

► We analysed independent associations, and interactions, of lack of economic capital (i.e., economic hardships) and social capital at the individual level on various health outcomes in Sweden（瑞典）.

► Findings add to the evidence that both economic hardships and social capital at the individual level contribute to a range of different health outcomes.

► When economic hardships and social capital are combined they potentiate the risk of poor health.

Keywords：Social determinants、Social capital、Economic hardships、Self-rated health

2019年，

愿我爱的祖国繁荣昌盛，

奋斗的人民幸福安康！