社会分层与健康不平等的性别差异:基于生命历程的纵向分析

摘要：

本研究考察在社会分层与性别分层的交互作用下，生命历程中的两个竞争性理论——“累积优势/劣势理论”和“年龄中和效应理论”，哪一个更能解释中国男性和女性所经历的健康不平等。本研究利用“中国健康与营养调查”（CHNS）追踪数据和成长曲线模型发现，性别对社会分层导致的健康不平等及其发展有独特的影响。与男性相比，女性在各个年龄阶段都处于健康劣势，这一劣势是因为女性从教育和收入所获得的健康回报比男性低。此外，女性之间因为教育和收入导致的健康不平等程度随年龄的增长而缩小，男性之间的健康不平等程度并不随年龄的增长而改变，因此，本研究不支持健康不平等的“累积优势/劣势假说”，而是在女性群体中支持“年龄中和效应理论”。

关键词: 累积优势/劣势, 年龄中和效应, 性别分层, 生命历程, 社会分层, 健康不平等

Abstract:

This paper is a longitudinal study of the relationship between gender,SES and health among Chinese men and women. The study draws its data from the Chinese Health and Nutrition Survey (CHNS) over a period of sixteen years and applies the growth curve model analysis in an attempt to address two concerns:Are there any gender differences in health dividend returns due to education and income? Does the SES-health gradient among men and women diverge or converge with aging? We attempt to test two competing theoretical propositions of life course health stratification in a gendered Chinese society:cumulative advantage/disadvantage vs. age-as-leveler. Results show that the SES-health gradient is smaller in China than in the West. Chinese women experience significantly poorer health than Chinese men at all age groups. This disparity can be explained solely by the low health returns received by women from education and income. Although as a whole,the Chinese gain less health reruns from education and income than their Western counterparts,Chinese men benefit more in health returns than Chinese women from their education and income. The study finds that the SES-health gradient for men stays consistent throughout life course while for women it converges with aging,a conclusion that supports the age-as-leveler hypothesis. In addition,we explore the effects of the customary unhealthy lifestyle of Chinese intellectuals as well as the impact of the rapidly changing Chinese society on gender inequality in health.

Key words: gender differences in health, life course perspective, health disparity, cumulative advantage and disadvantage, SES health gradients, age-as-leveler

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