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歧视有害:歧视对慢性疼痛发展的影响。

Discrimination hurts: The effect of discrimination on the development of chronic pain.

机构信息

School of Public Health, University of California, Berkeley, USA.

School of Public Health, University of California, Berkeley, USA.

出版信息

Soc Sci Med. 2018 May;204:1-8. doi: 10.1016/j.socscimed.2018.03.015. Epub 2018 Mar 8.

Abstract

We examine the hypothesis that psychological distress due to perceived discrimination can result in chronic pain, where perceived discrimination is based on age, gender, race, ethnicity, disability, sexual orientation, height/weight, religion, and other characteristics. Using a sample of 1908 individuals from the two most recent waves (2004-2006 and 2013-2014) of panel data from the National Survey of Midlife Development in the United States, we apply instrumental variables regression where measures of daily and lifetime perceived discrimination are instruments whose effects on chronic pain are mediated by psychological distress. We find statistically significant dose-response relationships between daily perceived discrimination and psychological distress, between lifetime perceived discrimination and psychological distress, and between psychological distress and chronic pain. Based on our instrumental variables regression model, we estimate that 4.1 million people in the US in 2016, aged 40 and older, experience chronic pain that is caused by increased psychological distress, where psychological stress has increased due to perceived discrimination.

摘要

我们检验了这样一个假设,即由于感知到的歧视而产生的心理困扰可能导致慢性疼痛,而感知到的歧视是基于年龄、性别、种族、民族、残疾、性取向、身高/体重、宗教和其他特征。本研究使用了来自美国全国中年发展纵向研究的两个最新面板数据(2004-2006 年和 2013-2014 年)中 1908 名个体的样本,我们应用了工具变量回归,其中日常感知歧视和终身感知歧视的测量值是工具变量,它们对慢性疼痛的影响是通过心理困扰来介导的。我们发现,日常感知歧视与心理困扰之间、终身感知歧视与心理困扰之间以及心理困扰与慢性疼痛之间存在统计学上显著的剂量反应关系。根据我们的工具变量回归模型,我们估计在 2016 年,美国有 410 万人患有由心理困扰增加引起的慢性疼痛,而这种心理压力是由于感知到的歧视而增加的。

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