Kiely Kim M, Leach Liana S, Olesen Sarah C, Butterworth Peter
Centre for Research on Ageing Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, ACT, 0200, Australia,
Soc Psychiatry Psychiatr Epidemiol. 2015 Jun;50(6):909-18. doi: 10.1007/s00127-015-1027-0. Epub 2015 Feb 17.
Poor mental health has been consistently linked with the experience of financial hardship and poverty. However, the temporal association between these factors must be clarified before hardship alleviation can be considered as an effective mental health promotion and prevention strategy. We examined whether the longitudinal associations between financial hardship and mental health problems are best explained by an individual's current or prior experience of hardship, or their underlying vulnerability.
We analysed nine waves (years: 2001-2010) of nationally representative panel data from the Household, Income, and Labour Dynamics in Australia survey (n = 11,134). Two components of financial hardship (deprivation and cash-flow problems) and income poverty were coded into time-varying and time-invariant variables reflecting the contemporaneous experience of hardship (i.e., current), the prior experience of hardship (lagged/12 months), and any experience of hardship during the study period (vulnerability). Multilevel, mixed-effect logistic regression models tested the associations between these measures and mental health.
Respondents who reported deprivation and cash-flow problems had greater risk of mental health problems than those who did not. Individuals vulnerable to hardship had greater risk of mental health problems, even at the times they did not report hardship. However, their risk of mental health problems was greater on occasions when they did experience hardship.
The results are consistent with the argument that economic and social programmes that address and prevent hardship may promote community mental health.
心理健康状况不佳一直与经济困难和贫困经历相关。然而,在将缓解困难视为有效的心理健康促进和预防策略之前,必须厘清这些因素之间的时间关联。我们研究了经济困难与心理健康问题之间的纵向关联,是由个人当前或先前的困难经历,还是其潜在的易感性来最好地解释。
我们分析了来自澳大利亚家庭、收入和劳动力动态调查的九轮(2001年至2010年)具有全国代表性的面板数据(n = 11134)。经济困难的两个组成部分(匮乏和现金流问题)以及收入贫困被编码为反映困难同期经历(即当前)、先前困难经历(滞后/12个月)以及研究期间任何困难经历(易感性)的随时间变化和不随时间变化的变量。多层次混合效应逻辑回归模型检验了这些指标与心理健康之间的关联。
报告有匮乏和现金流问题的受访者出现心理健康问题的风险高于未报告者。易受困难影响的个体出现心理健康问题的风险更大,即使在他们未报告困难的时候也是如此。然而,在他们确实经历困难的情况下,他们出现心理健康问题的风险更大。
结果与这样的观点一致,即解决和预防困难的经济和社会项目可能促进社区心理健康。