Williams Greg, Di Nardo Francesco, Verma Arpana
Manchester Urban Collaboration on Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PT, UK.
Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Eur J Public Health. 2017 May 1;27(suppl_2):68-73. doi: 10.1093/eurpub/ckx008.
Self-reported health status (SRHS) reflects an individual's perception of their social, biological and psychological health, and has been linked to increased mortality risk and increased use of health services. Having a psychological co-morbidity can reduce health outcomes and increase healthcare costs. This paper investigates the relationship between SRHS and signs of psychological distress (PD) in European urban settings. The study sample comprised 20 439 adult respondents to surveys conducted across 37 urban areas. Data on SRHS, signs of PD and potential confounders were analysed in a multivariable logistic regression. After adjusting for potential confounders (gender, age, time lived in country and regularity of contact with family and friends), a significant association was found between PD and self-reported poor health for all urban areas, particularly in Western European countries (adjusted OR = 3.615, 95% CI: 3.333-3.920 P < 0.001). Time lived in country of residence, financial stability and regularity of contact with family and friends were negatively associated with signs of PD in the adjusted model. There is a statistically significant association between self-reported poor health and signs of PD. Although the relationship was present in all geographical locations, the confounders were protective factors for Western European countries. Since the two factors are linked, interventions that target one might reduce the impact on both. Further study into causality would be of use in predicting future healthcare costs, which could be reduced by integrating their management.
自我报告的健康状况（SRHS）反映了个人对其社会、生理和心理健康的认知，并且与死亡风险增加以及医疗服务使用增加有关。患有心理合并症会降低健康结果并增加医疗成本。本文研究了欧洲城市环境中SRHS与心理困扰（PD）迹象之间的关系。研究样本包括对37个城市地区进行的调查中的20439名成年受访者。在多变量逻辑回归中分析了关于SRHS、PD迹象和潜在混杂因素的数据。在对潜在混杂因素（性别、年龄、在该国居住的时间以及与家人和朋友联系的规律性）进行调整后，发现所有城市地区的PD与自我报告的健康状况不佳之间存在显著关联，特别是在西欧国家（调整后的比值比=3.615，95%置信区间:3.333 - 3.920，P<0.001）。在调整后的模型中，在该国居住的时间、财务稳定性以及与家人和朋友联系的规律性与PD迹象呈负相关。自我报告的健康状况不佳与PD迹象之间存在统计学上的显著关联。尽管这种关系在所有地理位置都存在，但混杂因素对西欧国家来说是保护因素。由于这两个因素相互关联，针对其中一个因素的干预措施可能会减少对两者的影响。对因果关系的进一步研究将有助于预测未来的医疗成本，通过整合它们的管理可以降低这些成本。
