Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain.
Soc Psychiatry Psychiatr Epidemiol. 2012 Oct;47(10):1675-84. doi: 10.1007/s00127-012-0474-0. Epub 2012 Jan 25.
In the past few years, there has been increasing interest in studying the association between problems in the neighbourhood environment and health indicators. The objective of this study is to examine the relationship between the perception of environmental problems by individuals and the prevalence of common mental disorders (CMD) in Spain.
A cross-sectional study using data from a large scale national representative survey of households (the 2006 Spanish National Health Survey). Participants included in the study were aged between 16 and 64 years (n = 23,760). The dependent variable was common mental disorders assessed with the General Health Questionnaire (GHQ-12). The independent variable was the individual's perception of environmental problems. Raw and adjusted Odds Ratios and their confidence intervals (95%) were calculated by fitting logistic regression models adjusting for age, marital status, work situation, social class, rural or urban area, country of origin, restrictions in carrying out activities of daily life due to a health problem and social support.
The individuals who reported environmental problems had a higher prevalence of CMD. There was a clear increasing gradient in CMD prevalence with the increase in the number of environmental problems mentioned. Among the subjects who reported to have 1 or no environmental problem the prevalence of CMD was 11.8% (men) and 18.7% (women), and among those who mentioned 6 or more problems, the prevalence increased to 20.8% (men) and 35.4% (women). After adjusting for all the co-variables, there is an association between environmental problems and CMD (men OR 1.44, 95% CI 1.08-1.66; women OR 1.46, 95% CI 1.27-1.67). The environmental problems most strongly associated with the prevalence of CMD are noise, bad smell, air pollution, and lack of green areas.
Our findings show that individuals who perceive environmental problems in their neighbourhood have a higher prevalence of CMD, even after adjusting for all co-variables. In addition, there is a clear increasing gradient in the prevalence of CMD with the increase in the number of environmental problems. Efforts to reduce the prevalence of CMD must be directed to improve individual and contextual risks.
在过去的几年中,人们对研究邻里环境问题与健康指标之间的关系越来越感兴趣。本研究的目的是检验个体对环境问题的感知与西班牙常见精神障碍(CMD)患病率之间的关系。
这是一项使用大规模全国代表性家庭调查(2006 年西班牙国家健康调查)数据的横断面研究。研究对象为年龄在 16 至 64 岁之间的参与者(n=23760)。因变量为使用一般健康问卷(GHQ-12)评估的常见精神障碍。自变量为个体对环境问题的感知。通过拟合调整年龄、婚姻状况、工作状况、社会阶层、农村或城市地区、原籍国、因健康问题限制日常生活活动以及社会支持等因素的 logistic 回归模型,计算出未经调整和调整后的优势比及其 95%置信区间(95%CI)。
报告环境问题的个体患 CMD 的比例较高。提到的环境问题数量越多,CMD 的患病率就越高。在报告有 1 个或没有环境问题的人群中,CMD 的患病率为男性 11.8%(11.8%)和女性 18.7%(18.7%),而在报告有 6 个或更多环境问题的人群中,患病率上升至男性 20.8%(20.8%)和女性 35.4%(35.4%)。在调整所有协变量后,环境问题与 CMD 之间存在关联(男性 OR 1.44,95%CI 1.08-1.66;女性 OR 1.46,95%CI 1.27-1.67)。与 CMD 患病率关系最密切的环境问题是噪音、异味、空气污染和缺乏绿地。
我们的研究结果表明,即使在调整所有协变量后,那些认为邻里环境存在问题的个体患 CMD 的比例更高。此外,随着环境问题数量的增加,CMD 的患病率呈明显上升趋势。降低 CMD 患病率的努力必须针对改善个体和环境风险。