A critical reflection on the role of social democracy in reducing socioeconomic inequalities in health: a commentary on Sekine, Chandola, Martikainen, Marmot and Kagamimori.

摘要

In their article "Socioeconomic Inequalities in Physical and Mental Functioning of British, Finnish, and Japanese Civil Servants: Role of Job Demand, Control, and Work Hours" in this issue of Social Science & Medicine, Sekine and colleagues report on employment grade-related differences in mental and physical functioning in British, Japanese, and Finnish civil service workers (Sekine, Chandola, Martikainen, Marmot, & Kagamimori, 2009). In all three samples, the lower grades had worse physical functioning in both men and women when compared with the higher grades. Across samples and across men and women, a more complex pattern of findings was reported for mental functioning. For example, Finnish workers in the higher grades had the worst mental health outcomes. Adverse work characteristics (high job demands, low control, and too little or too many working hours) contributed only modestly to the above associations. The authors conclude that their findings may be explained by the different welfare regimes in the three countries, i.e., liberal, conservative, and social democratic regime in the British, Japanese, and Finnish samples, respectively. Previously, using the same data, the authors made comparisons regarding physical functioning, perceived health (Martikainen et al., 2004), and behavioral and biological risk factors (Martikainen, Ischizaki, Marmot, Nakagawa, & Kagamimori, 2001).