■不同的死亡风险与广泛的社会因素有关,不仅包括教育和收入,还包括其他经济和非经济资源。这项研究的目的是评估死亡风险与四种类型的资源的关联:经济,社会,文化和人力资本。
■我们使用了来自荷兰差异调查的2,952名参与者的数据以及2014年至2021年期间荷兰统计局的年度死亡率数据。经济资本是通过教育来衡量的,收入,职业,房屋净值,和流动资产。社会资本是用社会关系的强度来衡量的,核心讨论网络的规模,以及接触足智多谋的人;生活方式的文化资本,数字技能,和英语的掌握,和个人资本通过自我评估的健康,爬楼梯的障碍,自信,自我形象,人们的外表,和体重指数。为了适应每个资本都来自几个指标的事实,我们使用偏最小二乘(PLS)Cox回归。
■在多元回归中,更高的经济,文化,和人资本与较低的死亡率相关(危险比,0.77;95%置信区间[CI,0.65至0.90],0.77[0.64-0.93]和0.80;[0.70-0.92]),针对所有资本措施和性别进行了调整。
■发现更经济,文化资本和人力资本与较低的死亡率相关,为使用广泛的资本措施的方法提供了经验支持-迄今为止很少同时包括在流行病学研究中-以了解不同的死亡风险。通过整合社会学概念,队列数据,和流行病学研究方法,我们的研究强调需要进一步研究不同形式的资源在形成健康不平等方面的相互作用。在设计公共卫生干预措施时,我们主张采用基于资本的多维框架来解决死亡率的社会差距。
UNASSIGNED: Diverging death risks are associated with a wide range of social factors, including not only education and income but also other economic and non-economic resources. The aim of this study was to assess the association of mortality risks with four types of resources: economic, social, cultural and person
capital.
UNASSIGNED: We used data of 2,952 participants from the Disparities in the Netherlands survey and annual mortality data from Statistics Netherlands for the period 2014 to 2021. Economic
capital was measured through education, income, occupation, home equity, and liquid assets. Social
capital was measured by the strength of social ties, the size of the core discussion network, and access to people in resourceful positions; cultural capital by lifestyle, digital skills, and mastery of English, and person
capital by self-rated health, impediments to climbing stairs, self-confidence, self-image, people\'s appearance, and body mass index. To accommodate the fact that each
capital was derived from several indicators, we used Partial Least Squares (PLS) Cox Regression.
UNASSIGNED: In multiple regression, higher economic, cultural, and person capital were associated with lower mortality (hazard ratio, 0.77; 95% confidence interval [CI, 0.65 to 0.90], 0.77 [0.64-0.93] and 0.80; [0.70-0.92]), adjusted for all capital measures and sex.
UNASSIGNED: The finding that more economic, cultural and person capital is associated with lower mortality provides empirical support for an approach that uses a broad spectrum of capital measures - hitherto rarely included simultaneously in epidemiological research - in order to understand diverging death risks. By integrating sociological concepts, cohort data, and epidemiological research methods, our study highlights the need for further research on the interplay between different forms of resources in shaping health inequalities. In designing public health interventions, we advocate the adoption of a multidimensional capital-based framework for tackling social disparities in mortality.