| This report describes a multilevel city-wide profile of physical health
in Moscow, examining individual and urban level factors. Objectives of
the paper were to: (1) identify macro and micro risk factors for poor physical
health in Moscow;(2) assess the effect of two dimensions of micro determinants--personal
health habits and social connectivity, such as social cohesion, social
support, and social networks; (3) examine the hypothesis that relative
social inequality is a significant structural condition at the community
level which influences the physical health of individuals, as a main and
as a joint effect with psychosocial behaviors. A random sample of Moscow
adults, with household telephones (N = 2000), was collected 17-19 September,
1991, and had a completed interview rate of 81.8%. The questionnaire replicated
items from the California Alameda Study and the US Health Interview Survey.
Respondents' urban area of residence was linked to macro measures of inequality
derived from the Moscow census. This report describes the baseline survey
of a prospective study design. Results of this study demonstrate that the
social context in a community affects the health of people living there
independently from the effects of individual health lifestyle or social
connectivity. The structural conditions in Moscow which significantly increased
the vulnerability of specific social groups for poor physical health were
identified in a hierarchical linear regression: relative social inequality
in the form of income inequality; urban area poverty risks; and mean level
of alcohol consumption in urban areas. The psychosocial conditions included
poor diet, lack of social cohesion and social support, involvement in formal
social networks in the form of professional groups. A multilevel theoretical
perspective is important for defining the targets of preventive health
policy by identifying the structural conditions which increase the health
disadvantage of some social groups. Further research is needed in refining
the concept of relative social inequality, as well as investigating whether
psychosocial factors, such as social cohesion, are mediating links between
sick societies and their sick citizens.
PMID: 11037218 [PubMed - indexed for MEDLINE]
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