Okoro Catherine, Strine Tara, McGuire Lisa, Balluz Lina, Mokdad Ali
Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Occup Med (Lond). 2007 May;57(3):217-20. doi: 10.1093/occmed/kql177. Epub 2007 Jan 16.
It has been postulated that poor mental health can lead to disability and disability can lead to unemployment. However, the association between poor mental health and employment status among adults with disabilities has not been well characterized in population-based studies.
To examine the association between employment status and frequent mental distress (FMD; 14 or more mentally unhealthy days during the previous 30 days) among adults with disabilities.
Cross-sectional data were analysed for 47,377 community-dwelling US adults aged 25-64 years with disabilities that participated in the 2001 and 2003 Behavioural Risk Factor Surveillance System. Logistic regression analysis was applied.
Among adults with disabilities, the unadjusted prevalence of FMD was 18% (SE 0.4) among those employed, 40% (SE 1.3) among those unemployed and 44% (SE 0.8) among those unable to work. After adjustments were made for age, sex and race/ethnicity, the results indicated that adults with disabilities who were unemployed or unable to work were significantly more likely than those employed to have FMD (adjusted prevalence: 39 and 45%, respectively, versus 18%; P < 0.001). These associations persisted after further adjusting for education, marital status, health risk behaviours, body mass index, health care coverage and self-rated general health (34 and 36%, respectively, versus 19%; P < 0.001).
These findings demonstrate the need for research and development of public health interventions to reduce the toll of mental distress among all adults with disabilities.
据推测，心理健康状况不佳会导致残疾，而残疾又会导致失业。然而，在基于人群的研究中，残疾成年人心理健康状况不佳与就业状况之间的关联尚未得到充分描述。
研究残疾成年人的就业状况与频繁心理困扰（FMD；过去30天内有14天或更多天心理不健康）之间的关联。
对47377名年龄在25 - 64岁、居住在社区的美国残疾成年人的横断面数据进行分析，这些成年人参与了2001年和2003年的行为危险因素监测系统。应用逻辑回归分析。
在残疾成年人中，FMD的未调整患病率在就业者中为18%（标准误0.4），失业者中为40%（标准误1.3），无法工作者中为44%（标准误0.8）。在对年龄、性别和种族/族裔进行调整后，结果表明，失业或无法工作的残疾成年人比就业者患FMD的可能性显著更高（调整患病率：分别为39%和45%，而就业者为18%；P < 0.001）。在进一步对教育程度、婚姻状况、健康风险行为、体重指数、医疗保健覆盖范围和自我评定的总体健康状况进行调整后，这些关联仍然存在（分别为34%和36%，而就业者为19%；P < 0.001）。
这些发现表明需要开展研究并开发公共卫生干预措施，以减轻所有残疾成年人的心理困扰负担。
