民族密度对成年人心理健康的影响：国际研究的系统评价和荟萃分析。
Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies.
机构信息
Department of Social Statistics,University of Manchester,Manchester,UK.
Department of Health Services & Population Research,King's College London,Institute of Psychiatry, Psychology & Neuroscience,London,UK.
出版信息
Psychol Med. 2018 Sep;48(12):2054-2072. doi: 10.1017/S0033291717003580. Epub 2017 Dec 14.
BACKGROUND
Despite increased ethnic diversity in more economically developed countries it is unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes.
METHODS
We systematically searched Medline, PsychINFO, Sociological Abstracts, Web of Science from inception to 31 March 2016. We obtained additional data from study authors. We conducted random-effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation, and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences, and psychosis.
RESULTS
We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences [odds ratio (OR) 0.82 (95% confidence interval (CI) 0.76-0.89)] and suicidal ideation [OR 0.88 (95% CI 0.79-0.98)] for each 10 percentage-point increase in own ethnic density. For CMD, depression, and anxiety, associations were indicative of protective effects of own ethnic density; however, results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis.
CONCLUSIONS
The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.
背景
尽管在经济更为发达的国家，族裔多样性有所增加，但族裔少数群体聚居程度（族裔密度）对心理健康是否有害或有益尚不清楚。这是首次对国际文献进行的系统综述和荟萃分析，评估了族裔密度与心理健康结果之间的关联。
方法
我们系统地检索了 Medline、PsychINFO、Sociological Abstracts 和 Web of Science，检索时间从建库至 2016 年 3 月 31 日。我们还从研究作者那里获取了额外的数据。我们采用随机效应荟萃分析，考虑了数据集内估计值的聚类。元回归评估了因种族、国家、代际和地区贫困程度导致的研究间异质性。我们的主要暴露因素是族裔密度，定义为自身少数族裔群体的聚居程度。结局包括抑郁、焦虑和常见精神障碍（CMD）、自杀、自杀意念、精神病性体验和精神病。
结果
我们对综述进行了 41 项研究的分析，对 12 项研究进行了荟萃分析。荟萃分析发现，自身族裔密度每增加 10 个百分点，精神病性体验的相对比值比（OR）降低 0.82（95%可信区间（CI）0.76-0.89），自杀意念的 OR 降低 0.88（95% CI 0.79-0.98）。对于 CMD、抑郁和焦虑，关联表明自身族裔密度具有保护作用；然而，结果并不具有统计学意义。叙述性综述的结果与荟萃分析的结果一致。
结论
这些发现支持了在不同国家和族裔/种族少数群体中，族裔密度与心理健康结果之间存在一致的保护关联。这可能表明，社会环境对边缘化和受排斥群体的不良心理健康结果具有重要影响。
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