Akhter N, Bambra C, Mattheys K, Warren J, Kasim A
Wolfson Research Institute for Health and Wellbeing, Durham University, United Kingdom.
Fuse - UKCRC Centre for Translational Research in Public Health, United Kingdom.
SSM Popul Health. 2018 Aug 22;6:75-84. doi: 10.1016/j.ssmph.2018.08.004. eCollection 2018 Dec.
In response to the 2007/8 financial crisis and the subsequent 'Great Recession', the UK government pursued a policy of austerity, characterised by public spending cuts and reductions in working-age welfare benefits. This paper reports on a case study of the effects of this policy on local inequalities in mental health and wellbeing in the local authority of Stockton-on-Tees in the North East of England, an area with very high spatial and socio-economic inequalities. Follow-up findings from a prospective cohort study of the gap in mental health and wellbeing between the most and least deprived neighbourhoods of Stockton-on-Tees is presented. It is the first quantitative study to use primary data to intensively and longitudinally explore local inequalities in mental health and wellbeing during austerity and it also examines any changes in the underpinning social and behavioural determinants of health. Using a stratified random sampling technique, the data was analysed using linear mixed effects model (LMM) that explored any changes in the gap in mental health and wellbeing between people from the most and least deprived areas, alongside any changes in the material, psychosocial and behavioural determinants. The main findings are that the significant gap in mental health between the two areas remained constant over the 18-month study period, whilst there were no changes in the underlying determinants. These results may reflect our relatively short follow-up period or the fact that the cohort sample were older than the general population and pensioners in the UK have largely been protected from austerity. The study therefore potentially provides further empirical evidence to support assertions that social safety nets matter - particularly in times of economic upheaval.
针对2007/8年金融危机及随后的“大衰退”，英国政府推行了紧缩政策，其特点是削减公共开支和减少劳动年龄人口的福利。本文报告了一项案例研究，该研究探讨了这项政策对英格兰东北部蒂斯河畔斯托克顿地方当局心理健康和幸福方面的地方不平等现象的影响，该地区存在非常严重的空间和社会经济不平等。文中呈现了对蒂斯河畔斯托克顿最贫困和最不贫困社区之间心理健康和幸福差距的前瞻性队列研究的随访结果。这是第一项利用原始数据深入且纵向地探究紧缩时期心理健康和幸福方面地方不平等现象的定量研究，同时还考察了健康的社会和行为决定因素的任何变化。采用分层随机抽样技术，使用线性混合效应模型（LMM）对数据进行分析，该模型探究了最贫困和最不贫困地区人群之间心理健康和幸福差距的任何变化，以及物质、心理社会和行为决定因素的任何变化。主要研究结果是，在为期18个月的研究期间，两个地区之间心理健康的显著差距保持不变，而潜在决定因素没有变化。这些结果可能反映了我们相对较短的随访期，或者该队列样本比英国普通人群年龄更大且养老金领取者在很大程度上免受紧缩政策影响这一事实。因此，该研究可能提供了进一步的实证证据，以支持社会安全网很重要这一论断——尤其是在经济动荡时期。
