1Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Int J Soc Psychiatry. 2014 Mar;60(2):185-96. doi: 10.1177/0020764013481426. Epub 2013 Apr 16.
Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia.
The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level.
We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates.
One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03).
Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.
收入不平等与许多负面健康结果有关。有证据表明，生态层面的社会环境因素可能会增加精神分裂症的风险。
本研究旨在调查国家层面的收入不平等衡量指标是否与精神分裂症的发病率有关。
我们对 1975 年至 2011 年间报告的精神分裂症发病率进行了系统回顾。对于每个国家，我们获得了国家收入不平等（基尼系数）以及精神分裂症的协变量风险因素的衡量指标。采用多水平混合效应泊松回归来调查在控制协变量的情况下，基尼系数与精神分裂症发病率之间的关系。
共纳入了 107 个发病率（来自 26 个国家）。精神分裂症的平均发病率为 18.50/100,000（SD=11.9；范围=1.7-67）。精神分裂症发病率与基尼系数之间存在显著正相关（β=1.02；Z=2.28；p=0.02；95%CI=1.00,1.03）。
贫富差距较大的国家可能面临更高的精神分裂症风险。我们认为，收入不平等对社会凝聚力产生负面影响，侵蚀社会资本，而生活在差异巨大的社会中所带来的慢性压力使个体面临精神分裂症的风险。
