School of Sociology and Anthropology, Xiamen University, China.
Deparment of Social Work, Hong Kong Baptist University, Hong Kong, China; Department of Social Work and Social Administration, Faculty of Social Sciences, University of Hong Kong, Hong Kong, China.
Soc Sci Med. 2020 Nov;265:113308. doi: 10.1016/j.socscimed.2020.113308. Epub 2020 Aug 21.
Mental health and poverty remain pressing global challenges yet, their relationship has been neglected by international development policies, even in high income societies. This study aims to investigate the relationship between objective/subjective poverty and mental health and its potential mechanism.
A population-based data including 1,605 household heads extracted from the Hong Kong Panel Survey for Poverty Alleviation in 2015 were used. Multiple linear regression was conducted to examine the associations among poverty, negative life events, social support and mental health. Serial multiple mediation models were analyzed by the bootstrapping method to assess whether negative life events and social support mediate the relationship between objective/subjective poverty and mental health.
Subjective and objective poverty were significantly associated with higher risks of negative life events, less social support and mental distress (p < 0.001). Negative life events and social support in serial partially mediated the relationship between subjective poverty and mental health (total effect: Standardized β = 0.41,Standardized SE = 0.05, β = 2.07, 95% CI [1.59, 2.55]; total direct effect: Standardized β = 0.26, Standardized SE = 0.04, β = 1.34, 95% CI [0.86, 1.81]; total indirect effect: Standardized β = 0.14, Standardized SE = 0.04, β = 0.73, 95% CI [0.51,0.97]). By contrast, even though the total direct effect of objective poverty on mental distress was not statistically significant (Standardized β = 0.08, Standardized SE = 0.05, β = 0.41, 95% CI [-0.12, 0.94]), this relationship was also mediated by negative life events and social support (total effect: Standardized β = 0.21, Standardized SE = 0.06, β = 1.08, 95% CI [0.52, 1.65]; total indirect effect: Standardized β = 0.13, Standardized SE = 0.02, β = 0.67, 95% CI [0.43, 0.92]).
Social support including informational, instrumental and financial could be effective buffers that confer resilience against the negative effects of poverty and adverse life events on mental health. In addition, reducing perceived poverty seemed to be more effective in improving mental health compared to the objective poverty alleviation, and further research are needed to confirm this conclusion.
心理健康和贫困仍然是全球紧迫的挑战，但国际发展政策却忽视了它们之间的关系，即使在高收入社会也是如此。本研究旨在探讨客观/主观贫困与心理健康之间的关系及其潜在机制。
本研究使用了 2015 年香港扶贫情况住户调查中提取的 1605 户家庭户主的基于人群的数据。采用多元线性回归分析贫困、负性生活事件、社会支持与心理健康之间的关系。采用 bootstrap 法分析序列多重中介模型，以评估负性生活事件和社会支持是否在客观/主观贫困与心理健康之间起中介作用。
主观和客观贫困与较高的负性生活事件、较少的社会支持和心理困扰风险显著相关（p<0.001）。负性生活事件和社会支持在序列中介中部分中介了主观贫困与心理健康之间的关系（总效应：标准化β=0.41，标准化 SE=0.05，β=2.07，95%CI[1.59,2.55]；总直接效应：标准化β=0.26，标准化 SE=0.04，β=1.34，95%CI[0.86,1.81]；总间接效应：标准化β=0.14，标准化 SE=0.04，β=0.73，95%CI[0.51,0.97]）。相比之下，尽管客观贫困对心理困扰的总直接效应不具有统计学意义（标准化β=0.08，标准化 SE=0.05，β=0.41，95%CI[-0.12,0.94]），但这种关系也受到负性生活事件和社会支持的中介（总效应：标准化β=0.21，标准化 SE=0.06，β=1.08，95%CI[0.52,1.65]；总间接效应：标准化β=0.13，标准化 SE=0.02，β=0.67，95%CI[0.43,0.92]）。
包括信息、工具和财政支持在内的社会支持可以成为有效的缓冲，减轻贫困和逆境对心理健康的负面影响。此外，与客观减贫相比，减轻感知贫困似乎更能有效改善心理健康，需要进一步研究来证实这一结论。
