城市化与越南儿童心理健康和生活功能：对全球健康差距的影响。
Urbanization, and child mental health and life functioning in Vietnam: implications for global health disparities.
机构信息
Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
University of Education, Vietnam National University, Hanoi, Vietnam.
出版信息
Soc Psychiatry Psychiatr Epidemiol. 2020 Jun;55(6):673-683. doi: 10.1007/s00127-020-01838-4. Epub 2020 Feb 13.
PURPOSE
Urbanization is linked to increased health risks, including mental health. However, the large majority of this research has been conducted in high-income countries, and little is known about effects in low-and-middle-income countries (LMIC) where urbanization is occurring most frequently and most rapidly. Within global mental health, children and adolescents are a critical but understudied population. The present study assessed relations between urbanization factors, and child mental health in Vietnam, a Southeast Asian LMIC.
METHODS
Most studies investigating urbanization and mental health have used geographically based dichotomous urban vs. rural variables. Because of significant limitations with this approach, the present study assessed parent-reported urbanization factors (e.g., pollution, crime). In Sub-study #1 (cross-sectional), 1314 parents from 10 Vietnam provinces completed the Urbanization Factors Questionnaire, Child Behavior Checklist (mental health), and Brief Impairment Scale (life functioning). In Sub-study #2 (longitudinal), 256 parents from one highly urban and one highly rural province completed the same measures, at three timepoints across 12 months.
RESULTS
Cross-sectional canonical correlations identified relatively small (e.g., R = 0.08) but significant relations between urbanization factors, and child functioning. Parallel analyses using a geographically defined urban vs. rural variable did not produce significant results. The large majority of longitudinal relations between the different urbanization factors and child functioning were non-significant.
CONCLUSIONS
This study, among the first to assess urbanization as a multi-dimensional continuous construct in relation to child psychopathology, highlights the value of the use of an urbanization factors approach. A new "urbanization factors differentials" theory is proposed to suggest how effects of urbanization factors might result in global health disparities.
目的
城市化与健康风险的增加有关，包括心理健康。然而，这项研究的大部分是在高收入国家进行的，而对于城市化发生最频繁和最快的中低收入国家（LMIC）的影响却知之甚少。在全球心理健康领域，儿童和青少年是一个关键但研究不足的群体。本研究评估了城市化因素与越南儿童心理健康之间的关系，越南是东南亚的一个中低收入国家。
方法
大多数研究城市化与心理健康的关系都是使用基于地理的二分法城乡变量。由于这种方法存在严重的局限性，本研究评估了父母报告的城市化因素（例如污染、犯罪）。在子研究 #1（横断面研究）中，来自越南 10 个省份的 1314 位家长完成了城市化因素问卷、儿童行为检查表（心理健康）和简要功能障碍量表（生活功能）。在子研究 #2（纵向研究）中，来自一个高度城市化和一个高度农村化省份的 256 位家长在 12 个月的三个时间点完成了相同的测量。
结果
横断面典型相关分析确定了城市化因素与儿童功能之间相对较小（例如，R=0.08）但显著的关系。使用地理定义的城乡变量进行的平行分析并未产生显著结果。不同城市化因素与儿童功能之间的绝大多数纵向关系均不显著。
结论
这项研究首次评估了城市化作为一个多维连续结构与儿童精神病理学的关系，强调了使用城市化因素方法的价值。提出了一种新的“城市化因素差异”理论，以说明城市化因素的影响如何导致全球健康差异。
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