Nour Sabrina, Labonté Ronald, Bancej Christina
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Public Health Agency of Canada, Ottawa, Ontario, Canada.
J Epidemiol Community Health. 2017 Apr;71(4):336-343. doi: 10.1136/jech-2016-207661. Epub 2016 Nov 9.
Despite a clear impact on the Canadian economy, little is known about the subsequent health impacts of the 2008 global financial crisis (GFC) in this country. This study fills this gap in knowledge by conducting a repeated cross-sectional analysis of the Canadian Community Health Survey (CCHS).
Data from 7 cycles (2007-2013) of the CCHS were combined to form a large data set representative of the Canadian working-age population (15-64 years) residing in 1 of 10 provinces. A logistic regression model was used to determine whether exposure to various periods of the GFC resulted in increased odds of reporting poor mental health. Exposure was categorised into 4 periods based on political and economic indicators, as follows: precrisis period (baseline), initial crisis period, stimulus period and austerity period. Other outcomes investigated included: anxiety disorders (AD), mood disorders (MD), poor physical health and health-related behaviours (heavy alcohol drinking (HAD) and decreased fruit/vegetable consumption (FVC)).
A significant increased odds of reporting poor mental health was observed during the austerity period compared with the precrisis period (OR=1.26 (1.16 to 1.32)); findings remain significant when adjusted for sex, marital status and education. Exposure to the austerity period was also significantly associated with increased odds of reporting AD, MD, HAD and decreased odds of FVC. No significant associations were observed for the poor self-perceived physical health variable.
Statistically significant associations were observed between several negative health outcomes and the austerity period when compared with the precrisis period. Austerity has been linked to worsening health in other studies and represents an example of how the policy response can have greater detrimental impact on health than the financial crisis itself.
尽管2008年全球金融危机(GFC)对加拿大经济产生了明显影响,但该国随后的健康影响却鲜为人知。本研究通过对加拿大社区健康调查(CCHS)进行重复横断面分析,填补了这一知识空白。
将CCHS的7个周期(2007 - 2013年)的数据合并,形成一个代表居住在10个省份之一的加拿大工作年龄人口(15 - 64岁)的大型数据集。使用逻辑回归模型来确定暴露于GFC的不同时期是否会增加报告心理健康不佳的几率。根据政治和经济指标,暴露被分为4个时期,如下:危机前时期(基线)、初始危机时期、刺激时期和紧缩时期。调查的其他结果包括:焦虑症(AD)、情绪障碍(MD)、身体健康不佳以及与健康相关的行为(大量饮酒(HAD)和水果/蔬菜摄入量减少(FVC))。
与危机前时期相比,在紧缩时期报告心理健康不佳的几率显著增加(OR = 1.26(1.16至1.32));在对性别、婚姻状况和教育进行调整后,结果仍然显著。暴露于紧缩时期也与报告AD、MD、HAD的几率增加以及FVC的几率降低显著相关。对于自我感觉身体健康不佳这一变量,未观察到显著关联。
与危机前时期相比,在几个负面健康结果与紧缩时期之间观察到了具有统计学意义的关联。在其他研究中,紧缩与健康恶化有关,这代表了政策应对措施对健康的不利影响可能比金融危机本身更大的一个例子。