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社会保障に関するメモ帳

Altman et al. (2016) 主観的健康観は何を意味するか

主観的健康観は健康を測る一指標として広く使われている.その主観的健康観がどのように文脈化されているのかについて,「肥満ー主観的健康観」の関連からAPC分析を行った研究.肥満の人はそうでない人より健康状態が悪いと答えていることがわかった(APCで違いはあまりない).さらに,主観的健康観を主観的/客観的に要因分解したところ,肥満/非肥満の主観的健康観のギャップは,年齢の増加とともに客観的主観的健康観では広がり,主観的主観的健康観では縮まった.そのギャップは新しいコーホートについては,客観的主観的健康観で縮まり,主観的主観的健康観で広がったそうである.肥満に関する社会化が異なる可能性があると書かれているが,この辺りは細かく読んでみないとよく意味がわからない.

Altman, C. E., Van Hook, J., & Hillemeier, M. (2016). What Does Self-rated Health Mean? Changes and Variations in the Association of Obesity with Objective and Subjective Components Of Self-rated Health. Journal of Health and Social Behavior, 57(1), 39–58. 

Abstract

There are concerns about the meaning of self-rated health (SRH) and the factors individuals consider. To illustrate how SRH is contextualized, we examine how the obesity–SRH association varies across age, periods, and cohorts. We decompose SRH into subjective and objective components and use a mechanism-based age–period–cohort model approach with four decades (1970s to 2000s) and five birth cohorts of National Health and Nutrition Examination Survey data (N = 26,184). Obese adults rate their health more negatively than non-obese when using overall SRH with little variation by age, period, or cohort. However, when we decomposed SRH into objective and subjective components, the obesity gap widened with increasing age in objective SRH but narrowed in subjective SRH. Additionally, the gap narrowed for more recently born cohorts for objective SRH but widened for subjective SRH. The results provide indirect evidence that the relationship between obesity and SRH is socially patterned according to exposure to information about obesity and the availability of resources to manage it.