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澳大利亚老年女性的贫困与丧偶双重负担对其心理健康的影响:基于 HILDA 队列 17 年年度数据的纵向回归分析

The double burden of poverty and marital loss on the mental health of older Australian women; a longitudinal regression analysis using 17 annual waves of the HILDA cohort.

机构信息

Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, 3010, Australia.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2021 Jun;56(6):1059-1068. doi: 10.1007/s00127-020-02019-z. Epub 2021 Jan 7.

Abstract

PURPOSE

Compared to men, older women have poorer mental health and are more vulnerable to poverty, especially when living alone. However, few studies have examined how gender, marital status and poverty are inter-related and are associated with mental health. This study examines the gendered associations between relative poverty, marital status and mental health in older Australians.

METHODS

Drawing on 17 waves of the HILDA Survey, fixed-effects longitudinal regression analysis was utilised to examine the association between: (1) relative poverty (< 50% median household income) and mental health (MHI-5); (2) marital status and poverty, in a cohort of Australians aged 65 + years. We then examined effect modification of the association between relative poverty and mental health by marital status.

RESULTS

Within-person associations, stratified by gender, showed that women in relative poverty reported poorer mental health than when not in relative poverty, however no association was observed for men. Being divorced/separated was associated with increased odds of relative poverty for women, but not men. Widowhood was strongly associated with relative poverty in women, and also among men, albeit a smaller estimate was observed for men. There was no evidence of effect modification of the relationship between relative poverty and mental health by marital status for either men or women.

CONCLUSION

This study provides evidence that relative poverty is a major determinant of mental health in older Australian women. Addressing gender inequities in lifetime savings, as well as in division of acquired wealth post marital loss, may help reduce these disparities.

摘要

目的

与男性相比,老年女性的心理健康状况较差,更容易贫困,尤其是独居时。然而,很少有研究探讨性别、婚姻状况和贫困之间的相互关系以及与心理健康的关联。本研究考察了澳大利亚老年人群中相对贫困、婚姻状况和心理健康之间的性别关联。

方法

本研究利用 HILDA 调查的 17 个波次,采用固定效应纵向回归分析,检验了以下两者之间的关联:(1)相对贫困(<50%中位数家庭收入)与心理健康(MHI-5);(2)在 65 岁及以上的澳大利亚队列中,婚姻状况与贫困之间的关联。然后,我们检验了婚姻状况对相对贫困与心理健康之间关联的调节作用。

结果

按性别分层的个体内关联显示,相对贫困的女性比非相对贫困的女性报告的心理健康状况更差,但男性则没有观察到这种关联。离婚/分居与女性相对贫困的几率增加有关,但与男性无关。丧偶与女性的相对贫困密切相关,与男性也有关联,尽管对男性的估计较小。对于男性和女性,婚姻状况都没有对相对贫困与心理健康之间的关系产生调节作用。

结论

本研究提供了证据表明,相对贫困是澳大利亚老年女性心理健康的一个主要决定因素。解决女性在终身储蓄方面以及在婚姻损失后获得的财富分配方面的性别不平等问题,可能有助于减少这些差异。

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