“转换-坚持”对低阶层健康的保护作用及其机制

低社会阶层是不良健康状况最可靠的社会决定因素之一。然而, 很少有人理解为什么同样处于低阶层, 有些个体却能保持良好的健康状况。在大量实证研究的基础上, 研究者们发现“转换-坚持”策略这一心理因素能有效保护处于逆境中的低阶层者的健康, 使其免于受到疾病的侵扰。当个体面临持续或频繁的压力时, “转换-坚持”策略减轻了下丘脑-垂体-肾上腺轴的急性生理激活, 有效抑制了低阶层面临逆境时的生理应激反应, 随着时间的推移, 阻止了致病过程的发展; 同时, 该策略还减少了低阶层者的不良健康行为, 进而对健康起到保护作用。未来研究应在深入探索核心机制基础上开发出有效的干预方案, 为解决我国相对贫困问题中的健康贫困提供新的路径。

The protective effects of the “shift-and-persist” strategy on the health of the lower class and their mechanisms

Having lower socioeconomic status is one of the most well-established social predictors of poor health. However, little is known about why some lower-class individuals maintain good physical health despite experiencing adversity. From a large number of empirical studies, researchers have found that psychological factors such as the “shift-and-persist” strategy can effectively protect the health of lower-class individuals in adversity and prevent them from developing certain diseases. The present study shows that in the midst of adversity, some individuals find role models who teach them to trust others, better regulate their emotions, and focus on their future. A role model is any individual who serves as an attachment figure and provides inspiration to a child and can be a parent, extended family member, or teacher. Over a lifetime, lower-class individuals with such role models develop an approach to coping with stress that helps them accept pressures and reappraisals (shift) while enduring adversity by maintaining a sense of meaning and optimism (persist). In contrast, among higher-class individuals, proactive efforts to cope aimed at eliminating stressors and the pursuit of future goals may be more effective, given such individuals' greater access to resources for engaging in preventive behaviors, resolving situations, and influencing outcomes.