Mattheys K, Bambra C, Warren J, Kasim A, Akhter N
Centre for Health and Inequalities Research, Department of Geography, Durham University, DH1 3LE, United Kingdom.
Wolfson Research Institute for Health and Well-Being, Durham University, Queens Campus, TS17 6BH, United Kingdom.
SSM Popul Health. 2016 Apr 30;2:350-359. doi: 10.1016/j.ssmph.2016.04.006. eCollection 2016 Dec.
Since 2010, the UK has pursued a policy of austerity characterised by public spending cuts and welfare changes. There has been speculation - but little actual research - about the effects of this policy on health inequalities. This paper reports on a case study of local health inequalities in the local authority of Stockton-on-Tees in the North East of England, an area characterised by high spatial and socio-economic inequalities. The paper presents baseline findings from a prospective cohort study of inequalities in mental health and mental wellbeing between the most and least deprived areas of Stockton-on-Tees. This is the first quantitative study to explore local mental health inequalities during the current period of austerity and the first UK study to empirically examine the relative contributions of material, psychosocial and behavioural determinants in explaining the gap. Using a stratified random sampling technique, the data was analysed using multi-level models that explore the gap in mental health and wellbeing between people from the most and least deprived areas of the local authority, and the relative contributions of material, psychosocial and behavioural factors to this gap. The main findings indicate that there is a significant gap in mental health between the two areas, and that material and psychosocial factors appear to underpin this gap. The findings are discussed in relation to the context of the continuing programme of welfare changes and public spending cuts in the UK.
自2010年以来，英国推行了一项以削减公共开支和改革福利为特征的紧缩政策。关于这项政策对健康不平等的影响一直存在猜测，但实际研究很少。本文报告了对英格兰东北部蒂斯河畔斯托克顿地方当局地区的当地健康不平等情况的一项案例研究，该地区的特点是空间和社会经济不平等程度很高。本文介绍了一项前瞻性队列研究的基线结果，该研究针对蒂斯河畔斯托克顿最贫困和最不贫困地区之间的心理健康和幸福不平等情况。这是第一项探索当前紧缩时期当地心理健康不平等情况的定量研究，也是英国第一项实证研究物质、心理社会和行为决定因素在解释差距方面相对贡献的研究。使用分层随机抽样技术，数据通过多层次模型进行分析，该模型探讨了地方当局最贫困和最不贫困地区人群之间的心理健康和幸福差距，以及物质、心理社会和行为因素对这一差距的相对贡献。主要研究结果表明，这两个地区在心理健康方面存在显著差距，物质和心理社会因素似乎是这一差距的基础。研究结果结合英国持续的福利改革和公共开支削减计划的背景进行了讨论。
