Costello E J, Keeler G P, Angold A
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Am J Public Health. 2001 Sep;91(9):1494-8. doi: 10.2105/ajph.91.9.1494.
This study examined the effect of poverty on the prevalence of psychiatric disorder in rural Black and White children.
A representative sample of 541 Black children and 379 White children aged 9 to 17 was drawn from 4 predominantly rural counties. Structured interviews with parents and children collected information on psychiatric disorders, absolute and relative poverty, and risk factors for psychiatric disorder.
Three-month prevalence of psychiatric disorder was similar to that found in other community samples (20%). Federal criteria for poverty were met by 18% of the White and 52% of the Black families. Black and White children were exposed to equal numbers of risk factors overall, but the association between poverty and psychopathology was stronger for White children (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1, 4.2) than for Black children (OR = 1.5; 95% CI = 0.9, 2.6). Family history of mental illness, poor parenting, and residential instability mediated this association in both groups.
In this rural sample, poverty was only weakly associated with child psychiatric disorders. Risk factors for both racial/ethnic groups were family mental illness, multiple moves, lack of parental warmth, lax supervision, and harsh punishment.
本研究调查了贫困对农村黑人和白人儿童精神障碍患病率的影响。
从4个主要为农村的县抽取了541名9至17岁的黑人儿童和379名白人儿童作为代表性样本。对家长和孩子进行结构化访谈,收集有关精神障碍、绝对贫困和相对贫困以及精神障碍风险因素的信息。
精神障碍的三个月患病率与其他社区样本中的患病率相似(20%)。18%的白人家庭和52%的黑人家庭符合联邦贫困标准。总体而言,黑人和白人儿童面临的风险因素数量相同,但贫困与精神病理学之间的关联在白人儿童中更强(优势比[OR]=2.1;95%置信区间[CI]=1.1,4.2),而在黑人儿童中较弱(OR=1.5;95%CI=0.9,2.6)。两组中,精神疾病家族史、不良养育方式和居住不稳定介导了这种关联。
在这个农村样本中,贫困与儿童精神障碍的关联较弱。两个种族/族裔群体的风险因素都是家族精神疾病、多次搬家、缺乏父母温暖、监管宽松和严厉惩罚。