Biology and Health Inequality 英文参考文献.docVIP

Essay Biology and Health Inequality Eric Brunner of employment and death from all causes—CHD and noncoronary causes [2]. The relative risk of death due to CHD was 2.2 in clerical compared with senior administrative staff, and 1.6 for those in the intermediate professional and executive grade. This working community shared a benign environment at the time of the baseline screening examination in 1968, important features of which included growing prosperity, the welfare state, and free health care. Nevertheless, a health hierarchy persisted that produced a greater than 2-fold examination in 1985–1988. Individuals have been followed through regular contacts, medical records, cancer registrations, and death certi?cates for over 20 years. There have been 737 (7.2%) deaths in the cohort to July 2006. The choice of civil servants is, to an extent, for convenience, because it is comparatively easy to keep track of participants. We are also studying a strati?ed institution within which men and women are subjected to an imposed work hierarchy—an illuminating population to study. We observed many health disparities that are important from a public difference in mortality, even across D social strata limited to men in secure, non-manual employment. Mortality gradients in the study re?ected those in United Kingdom social class mortality data in the 1970s, which continue today. The then-novel technique of multivariate modeling shed light on some of the causes of the inverse social gradient in CHD in the ?rst Whitehall study and helped to shape the future research agenda. When conventional coronary risk factors—such as smoking, serum cholesterol, and blood pressure—were controlled for one- third of the gradient was explained. Importantly, serum cholesterol levels were slightly higher in men in the higher employment grades [1]. The distribution of serum cholesterol in a population is a key determinant of its background level of risk, but it did not contribute to the social gradie