School of Public Health, University of California, Los Angeles 90095-1772, USA.
J Health Soc Behav. 2009 Dec;50(4):377-94. doi: 10.1177/002214650905000401.
Mental health disparities refer to the disproportionate amount of psychopathology found among persons of disadvantageous social standing, such as persons of low socioeconomic status (SES). Although social and self selection cannot entirely be ruled out as explanations for these differences, the accumulation of evidence supports a social causation interpretation for a large portion of this association for many disorders. The stress process model is applied to understand how social inequities become mental health disparities. Data from the Los Angeles Depression Study, originated by Leo Reeder are used to illustrate the key idea that explicit causal models are essential to the development of programmatic interventions to alleviate mental health disparities, as distinct from interventions to improve mental health in general. In light of recent work on neighborhood stratification and mental health, I advocate the modification of the social contexts of the stress process.
心理健康差距是指在处于不利社会地位的人群中,如社会经济地位较低的人群中,发现的不成比例的精神病理学数量。尽管不能完全排除社会和自我选择作为这些差异的解释,但大量证据支持了一种社会因果关系的解释,即许多障碍的大部分都与这种关联有关。应激过程模型被用来理解社会不平等如何成为心理健康差距。莱奥·里德(Leo Reeder)发起的洛杉矶抑郁研究的数据被用来举例说明一个关键思想,即明确的因果模型对于制定减轻心理健康差距的计划干预措施至关重要,而不是改善一般心理健康的干预措施。鉴于最近关于邻里分层和心理健康的研究,我主张修改应激过程的社会环境。