运用双重差分法，通过福岛健康管理调查探讨新冠疫情与福岛核灾受害者经济状况及心理健康之间的关联
Associations of the COVID-19 pandemic with the economic status and mental health of people affected by the Fukushima disaster using the difference-in-differences method: The Fukushima Health Management Survey.
作者信息
Murakami Michio, Kobayashi Tomoyuki, Oikawa Yuichi, Goto Saori, Momoi Maho, Takebayashi Yoshitake, Ohira Tetsuya, Yasumura Seiji, Maeda Masaharu
机构信息
Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Department of Health Risk Communication, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
出版信息
SSM Popul Health. 2021 Apr 15;14:100801. doi: 10.1016/j.ssmph.2021.100801. eCollection 2021 Jun.
Although the coronavirus disease 2019 (COVID-19) pandemic and relevant preventive measures can affect the economic status and mental health of the public, their effect remains unraveled owing to a limited number of surveys conducted before and during the COVID-19 pandemic. We investigated the association of COVID-19 and relevant measures with multivariate outcomes among people affected by the Fukushima disaster in 2011 using the difference-in-differences (DID) method. We then analyzed the associations between sociodemographic factors and outcomes. We assessed psychological distress, problem drinking, insomnia state, unemployment, household economic decline, and interpersonal problems using three questionnaire surveys administered in 2018, 2019, and 2020. Participants were grouped according to three time periods by dates of voluntary stay-at-home requests (February 26) and the declaration of emergency (April 16) in Japan. The years 2020 and 2019 were regarded as the treatment group and control group, respectively, after confirming that no DIDs were found between 2018 and 2019. We performed regression analyses to identify the risk factors for outcomes. The DIDs were significant for household economic decline after the declaration of emergency, whereas problem drinking significantly improved. No significant DIDs were observed for other mental health outcomes including psychological distress and insomnia state. Absence of counselors was positively and significantly associated with all outcomes in 2020. Overall, people affected by the Fukushima disaster experienced more economic damage after the declaration of emergency during the COVID-19 pandemic but their mental health status did not reduce. Identifying people who have no counselors and providing them with support are emergent requirements to prevent a subsequent mental health decline.
尽管2019冠状病毒病（COVID-19）大流行及相关预防措施会影响公众的经济状况和心理健康，但由于在COVID-19大流行之前和期间进行的调查数量有限，其影响仍未明确。我们使用双重差分（DID）方法，调查了COVID-19及相关措施与2011年受福岛灾难影响人群的多变量结果之间的关联。然后，我们分析了社会人口学因素与结果之间的关联。我们使用在2018年、2019年和2020年进行的三项问卷调查，评估了心理困扰、问题饮酒、失眠状态、失业、家庭经济衰退和人际关系问题。参与者根据日本自愿居家要求日期（2月26日）和紧急声明日期（4月16日）分为三个时间段。在确认2018年至2019年之间未发现双重差分后，将2020年和2019年分别视为治疗组和对照组。我们进行了回归分析，以确定结果的风险因素。紧急声明后家庭经济衰退的双重差分具有统计学意义，而问题饮酒情况则显著改善。在包括心理困扰和失眠状态在内的其他心理健康结果方面，未观察到显著的双重差分。2020年，缺乏咨询师与所有结果均呈正相关且具有统计学意义。总体而言，受福岛灾难影响的人群在COVID-19大流行期间紧急声明发布后遭受了更多经济损失，但其心理健康状况并未下降。识别没有咨询师的人群并为他们提供支持是防止随后心理健康下降的迫切需求。
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