社会不平等和个人心理资源在俄罗斯和欧洲社会重大疾病发病率中的作用

N. Rusinova, S. Boyarkina
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引用次数: 1

摘要

个体的心理资源是保持健康的重要因素。具有这样的心理特征,如意识到自己有能力控制生活环境,积极地认识自己,相信自己的力量,自尊,对未来持乐观态度,对一个人的身心状态有直接的积极影响,促进健康的生活方式,具备应对斗争的能力,减少压力对健康的影响。这类心理资源的提供及其储备对患有严重的社会慢性疾病并伴有身体和功能限制、违反心理和社会适应的人尤其重要。然而,根据许多研究,在社会上处于不利地位的人口群体中————受教育程度低、从事最不体面和低收入的工作,加上慢性病发病率和过早死亡的风险很高————由于心理资源短缺,心理抗拒率很低。对影响不同社会阶层代表健康的社会地位和个人心理资源之间关系的研究,使我们能够确定两种主要方法。在一种方法的框架内,心理特征被认为是决定其在社会中分配不平等的结构条件的产物。社会弱势群体代表所经历的心理资源不足被认为是造成社会经济地位低下对健康产生负面影响的原因之一,也是将社会经济差异转化为健康不平等的中介机制之一。另一种方法强调个人在改变生活环境方面的作用,包括那些由于低社会经济地位的不利影响而造成的生活环境。在这种情况下,注意力不是集中在社会经济阶层中占据不同地位的个人心理储备的差异上,而是集中在他们在一个社会水平内的可变性上。实证研究证实,特别是在社会弱势群体中,具有更多积极心理特质储备的个人比那些被剥夺这种储备的同胞表现出更好的健康状况。在文献中,这种现象被认为是一种"缓冲"效应,有助于减少低地位对健康的负面影响,从而减少健康方面的社会结构不平等。在欧洲发达国家,政府的保障使较低的社会阶层能够保持自尊、对未来的信心和乐观,心理资源失去了其作为社会经济地位和健康之间的调解人的作用,并可能导致减少结构性不平等的缓冲。在欧洲欠发达国家和俄罗斯,公共卫生和教育方案不允许来自较低阶层的人保持心理稳定,慢性病和过早死亡风险的结构性差异仍然存在。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of social inequality and individual psychological resources in the incidence of socially significant diseases in Russia and Europe
Psychological resources of the individual are an important factor of keeping health. Having such psychological features as awareness of their ability to control the life circumstances, a positive perception of themselves and belief in their own strength, self-esteem, optimistic view in the future, have a direct positive impact on the physical and psychological state of a person, promote healthy lifestyles, equip with the ability to cope struggles and reduce stress influence to health. The availability of such psychological resources and their reserve is especially important for people suffering from socially significant chronic diseases accompanied by physical and functional limitations, violations of psychological and social adaptation. However, according to numerous studies, in socially disadvantaged groups of the population – poorly educated, employed in the least prestigious and low-paid jobs with low incomes, together with high risks of morbidity and premature mortality from chronic diseases, there are low rates of psychological resistance due to a shortage of psychological resources. The study of the relationship between social status and individual psychological resources, which affect the health of different social strata’s representatives, allowed us to identify two main approaches. Within the framework of one approach, psychological features are considered to be a product of the structural conditions that determine the inequalities of their distribution in society. The deficit of psychological resources that experienced by representatives of socially vulnerable groups is consider to be contributing the negative impact of low socio-economic status on health and acts as one of the mediating mechanism for the transformation of socio-economic differences into inequalities in health. Another approach emphasizes the role of the person in changing the life circumstances, including those of them that are caused by the adverse effects of low socio-economic status. In this case, attention is focused not so much on the differences in the psychological reserves of individuals who occupy different positions in the socio-economic stratification, as on their variability within one social level. Empirical studies confirm that especially among the socially disadvantaged groups, individuals characterized by greater reserve of positive psychological properties, demonstrate significantly better health compared to those fellow citizens who are deprived of this reserve. In the literature, this phenomenon designates as a" buffer" effect, contributing to the reduction of negative health consequences of low status, and, consequently, to the reduction of socio-structural inequalities in health. In developed European countries, where government guarantees allow lower social strata to maintain self-esteem, confidence in the future and optimism, psychological resources lose their role as a mediator between socio-economic status and health and can lead to a buffer reduction of structural inequalities. In the less developed countries of Europe and in Russia, where public health and education programs do not allow people from the lower strata to maintain psychological stability, structural differences in the risks of chronic diseases and premature mortality persist.
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