Fernald Lia C H, Hamad Rita, Karlan Dean, Ozer Emily J, Zinman Jonathan
School of Public Health, University of California, Berkeley, USA.
BMC Public Health. 2008 Dec 16;8:409. doi: 10.1186/1471-2458-8-409.
In the developing world, access to small, individual loans has been variously hailed as a poverty-alleviation tool - in the context of "microcredit" - but has also been criticized as "usury" and harmful to vulnerable borrowers. Prior studies have assessed effects of access to credit on traditional economic outcomes for poor borrowers, but effects on mental health have been largely ignored.
Applicants who had previously been rejected (n = 257) for a loan (200% annual percentage rate - APR) from a lender in South Africa were randomly assigned to a "second-look" that encouraged loan officers to approve their applications. This randomized encouragement resulted in 53% of applicants receiving a loan they otherwise would not have received. All subjects were assessed 6-12 months later with questions about demographics, socio-economic status, and two indicators of mental health: the Center for Epidemiologic Studies - Depression Scale (CES-D) and Cohen's Perceived Stress scale. Intent-to-treat analyses were calculated using multinomial probit regressions.
Randomization into receiving a "second look" for access to credit increased perceived stress in the combined sample of women and men; the findings were stronger among men. Credit access was associated with reduced depressive symptoms in men, but not women.
Our findings suggest that a mechanism used to reduce the economic stress of extremely poor individuals can have mixed effects on their experiences of psychological stress and depressive symptomatology. Our data support the notion that mental health should be included as a measure of success (or failure) when examining potential tools for poverty alleviation. Further longitudinal research is needed in South Africa and other settings to understand how borrowing at high interest rates affects gender roles and daily life activities. CCT: ISRCTN 10734925.
在发展中世界，获得小额个人贷款在“小额信贷”背景下被广泛赞誉为一种扶贫工具，但也被批评为“高利贷”，对弱势借款人有害。先前的研究评估了获得信贷对贫困借款人传统经济成果的影响，但对心理健康的影响在很大程度上被忽视了。
曾被南非一家贷款机构（年利率200%）拒绝贷款的申请人（n = 257）被随机分配接受“二次审查”，鼓励信贷员批准他们的申请。这种随机鼓励使得53%的申请人获得了原本不会得到的贷款。6至12个月后，所有受试者接受了关于人口统计学、社会经济地位以及两个心理健康指标的问卷调查：流行病学研究中心抑郁量表（CES-D）和科恩感知压力量表。使用多项概率单位回归进行意向性分析。
随机接受信贷“二次审查”会增加男女混合样本中的感知压力；在男性中这一结果更为明显。获得信贷与男性抑郁症状减轻相关，但与女性无关。
我们的研究结果表明，一种用于减轻极端贫困人口经济压力的机制可能会对他们的心理压力体验和抑郁症状产生复杂的影响。我们的数据支持这样一种观点，即在考察潜在扶贫工具时，心理健康应被纳入成功（或失败）的衡量标准。在南非和其他地区需要进一步开展纵向研究，以了解高息借贷如何影响性别角色和日常生活活动。临床试验注册号：ISRCTN 10734925。
