社区特征、个人社会经济地位与老年人健康及其不平等

摘要/Abstract

摘要： 以往对老年人健康水平及其不平等现象的研究多从个体社会地位、关系网络的角度展开,较少关注外在于个体的宏观社会结构、社会资源因素可能引发的健康风险与潜在的健康不平等问题。本文利用clds2014年的数据拟合多层次模型,考察个人社会经济地位、社区社会结构和社会资本对老年人健康水平与不平等现象的影响机制。研究发现:不同社会经济特征的老年人在健康水平上存在明显的差异;社区特征对老年人健康水平存在着独立于个人因素的整体性影响,并对老年人健康不平等现象产生弱化与强化两种调节机制。(1)社区阶层异质性的分化程度会影响健康水平。其中,社区社会经济地位会弱化健康不平等,而社区内部阶层异质性则会强化健康不平等。(2)社区社会资本的培育能够显著提升老年人的健康水平并弱化健康不平等。因此,健康中国战略的实施要着眼于中国的健康分层现象,采取社区层面的健康干预,尽可能地增加弱势群体的健康资本。

关键词: 社区阶层异质性, 社区社会资本, 社会经济地位, 健康不平等

Abstract: Previous research on the health status and inequality among older adults has often focused on individual social status and relational networks, while paying less attention to the potential health risks and disparities stemming from macro-level social structures and social resource factors external to the individual. This study utilizes data from the CLDS2014 to fit a multilevel model to investigate the influence mechanism of individual socioeconomi. The research findings indicate that older adults with different socioeconomic characteristics exhibit significant disparities in health status. Community characteristics exert a holistic influence on the health status of older adults independent of individual factors and give rise to two types of regulatory mechanisms that either weaken or strengthen health inequalities among older adults. (1) The degree of community class heterogeneity will affect the health level. The community socioeconomic status will weaken the health inequality, and the class heterogeneity within the community will strengthen the health inequality.(2) Cultivating community social capital significantly enhances the health status of older adults and mitigates health inequalities. Therefore, the implementation of the Healthy China strategy should focus on the hierarchical health disparities in China, adopt health interventions at the community level, and endeavor to increase the health capital of vulnerable groups as much as possible.

Key words: community class heterogeneity, community social capital, socioeconomic status, health inequality

中图分类号:

C913.6

胡荣, 段晓雪. 社区特征、个人社会经济地位与老年人健康及其不平等[J]. 贵州财经大学学报, 2024(03): 72-80.

HU Rong, DUAN Xiaoxue. Community Characteristics, Socioeconomic Status, Health and its Inequality of the Elderly[J]. Journal of Guizhou University of Finance and Economics, 2024(03): 72-80.

参考文献

[1] 威廉·科克汉姆.医学社会学[M].北京:中国人民大学出版社,2012.
[2] Marmot M. Status Syndrome[J]. Significance, 2004, 1(4):150~154.
[3] 齐亚强.地位综合征:社会分层与健康不平等[M].北京:社会科学文献出版社,2020.
[4] 蔡禾,徐金福.城市社区与居民健康——基于2018CLDS数据的多层次分析[J].山东社会科学, 2022(2):176~185.
[5] Laura H, Quevedo L,et al. Effects of Social Mobility on Adult Mental Health:A Systematic Review of the Literature[J]. Cien Saude Colet, 2016,21(2):443~448.
[6] Lutfey K, Freese J. Toward some Fundamentals of Fundamental Causality:Socioeconomic status and Health in the Routine Clinic Visit for Diabetes[J]. American Journal of Sociology,2005,110(6):1326~1372.
[7] Kumar K, Shukla A, Singh A,et al.. Association Between Wealth and Health among Older adults in Rural China and India[J]. TheJournal of the Economics of Ageing, 2016,7:43~52.
[8] 徐岩. 客观社会经济地位、主观阶层认知与健康不平等[J]. 开放时代, 2017(4):191~207.
[9] Link B G, Phelan J C.Social Conditions AS Fundamental Causes of Disease[J].Journal of Health and Social Behavior, 1995(35):80~94.
[10] 焦开山. 健康不平等影响因素研究[J]. 社会学研究, 2014,29(5):24~46.
[11] 王甫勤,马瑜寅.社会经济地位、社会资本与健康不平等[J].华中科技大学学报(社会科学版),2020,34(6):59~66.
[12] 王甫勤. 社会流动有助于降低健康不平等吗?[J]. 社会学研究, 2011(2):78~101.
[13] Mirowsky J, Ross C E. Education and Self~Rated Health:Cumulative Advantage and Its Rising Importance[J]. Research on aging, 2008,30(1):93~122.
[14] Dupre M E. Educational Differences in Health Risks and Illness over the Life Course:A Test of Cumulative Disadvantage Theory[J]. Social Science Research, 2008,37(4):1253~1266.
[15] Avison W R, Aneshensel C S, Schieman Set al. Advances in the Conceptualization of the Stress Process[M]. Advances in the Conceptualization of the Stress Process:Essays in Honor of Leonard I. Pearlin, 2010.
[16] Yen I H, Michael Y L, Perdue L. Neighborhood Environment in Studies of Health of Older Adults:a Systematic Review[J]. American Journal of Preventive Medicine, 2009,37(5):455~463.
[17] 王志成, 郭岩. 中国社区社会经济地位和成人自评健康的关联研究[J]. 北京大学学报(医学版), 2021,53(2):314~319.
[18] 梁樱. 社区特征与中国农村老人的抑郁症状[J]. 北京社会科学, 2018(5):105~116.
[19] Dapontecodina A,Julia B,Silvia T,et al..Area Deprivation and Trends in Inequalities in Self~Rated Health in Spain, 1987~2001.[J].Scandinavian Journal of Public Health, 2008, 36(5):504~515.
[20] 马健囡, 王德文. 社区环境与个人因素对居民健康的交叉影响[J]. 东南学术, 2022(3):104~115.
[21] Ross C E, Mirowsky J. Neighborhood Disadvantage, Disorder, and Health[J]. Journal of Health and Social Behavior, 2001,42(3):258~276.
[22] 李洁瑾, 黄荣贵, 冯艾. 城市社区异质性与邻里社会资本研究[J]. 复旦学报(社会科学版),2007(5):67~73.
[23] 杨淑芳, 张朋柱. 基于智慧健康养老社区的老年人孤独感探究[J]. 北京理工大学学报(社会科学版), 2022,24(6):104~115.
[24] 郭慧玲. 由心至身:阶层影响身体的社会心理机制[J]. 社会, 2016,36(2):146~166.
[25] 帕特南.使民主运转起来:现代意大利的公民传统[M].北京:中国人民大学出版社,2015.
[26] Browning C R, Cagney K A. Neighborhood Structural Disadvantage, Collective Efficacy, and Self~Rated Physical Health in an Urban Setting[J]. Journal of Health and Social Behavior, 2002,43(4):383.
[27] Drukker M, Kaplan C, Feron F, et al.. Children's Health~Related Quality of Life, Neighbourhood Socio~Economic Deprivation and Social Capital. A Contextual Analysis[J]. Social Science & Medicine (1982), 2003,57(5):825~841.
[28] Kawachi I. Social Capital and Community Effects on Population and Individual Health.[J]. Annals of the New York Academy of Sciences, 2010,896:120~130.
[29] 方浩. 社会资本对城乡老年人健康影响的实证研究——基于CGSS混合截面数据[J]. 华中农业大学学报(社会科学版), 2020(2):88~97.
[30] 詹婧, 赵越. 身体健康状况、社区社会资本与单位制社区老年人主观幸福感[J]. 人口与经济, 2018(3):67~80.
[31] 蔡文聪, 杨海钰, 李星光, 等. 收入、社会资本对农民阶层自我定位的影响[J]. 湖南农业大学学报(社会科学版), 2020,21(2):27~34.
[32] 梁童心, 齐亚强, 叶华. 职业是如何影响健康的——基于2012年中国劳动力动态调查的实证研究[J]. 社会学研究, 2019,34(4):193~217.
[33] 文太林.社区养老、阶层差异与老年人心理健康[J]. 暨南学报(哲学社会科学版), 2021,43(5):54~63.
[34] Cohen M P. Determining Sample Size for Surveys with Data Analyzed by Hierarchical Linear Models[J]. Journal of Official Stats, 1998,14(3):267~275.
[35] 陆杰华, 郭冉. 基于地区和社区视角下老年健康与不平等的实证分析[J]. 人口学刊, 2017,39(2):57~67.
[36] 王辛,郭丹,梁佳瑞,等.社会资本对老年人健康促进行为的影响[J].山东大学学报(医学版),2021,59(7):97~103.