Coid Jeremy, Zhang Yingzhe, Ullrich Simone, Wood Jane, Bhavsar Vishal, Bebbington Paul, Bhui Kamaldeep
Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
BMC Public Health. 2021 Jun 12;21(1):1121. doi: 10.1186/s12889-021-11167-z.
Glasgow, Scotland, has previously shown exceptional levels of violence among young men, shows aggregations of health conditions, with shortened life expectancy. Health conditions can be both causes and consequences of violence, of shared community-level socio-economic risk factors, and can result from large-scale social forces beyond the control of populations with high levels of violence. The aim of the study was to provide an in depth understanding of the Public Health problem of violence among young adult men in Glasgow East.
Ecological investigation of violence and its associations with health conditions in areas of contrasting socioeconomic deprivation. National survey of 1916 British men aged 18-34 years, augmented by a sub-sample of 765 men in Glasgow East (GE). Participants completed questionnaires covering current physical and sexual health, psychiatric symptoms, substance misuse, lifestyle, and crime and violence.
The 5-year prevalence of violence was similar in both surveys but fights involving weapons (AOR 3.32, 95% CI 2.29-4.79), gang fights (AOR 2.30, 95% CI 1.77-2.98), and instrumental violence supporting criminal lifestyles were more common in GE, where 1 in 9 men had been in prison. Violent men in both samples reported poorer physical and sexual health and all types of psychiatric morbidity except depression, with multiple high-risk behaviours for both future poor health and violence. Associations between drug and alcohol dependence and violence in GE could not be entirely explained by deprivation.
Violence in deprived urban areas is one among many high-risk behaviours and lifestyle factors leading to, as well as resulting from, aggregations of both psychiatric and physical health conditions. Poverty partly explained raised levels of violence in GE. Other factors such as drug and alcohol misuse and macho attitudes to violence, highly prevalent among men in this socially excluded community, also contributed. Multi-component preventive interventions may be needed in deprived areas and require future investigations into how multiple co-existing risk factors produce multimorbidity, including psychiatric disorders, substance misuse, poor physical health and violence.
苏格兰格拉斯哥此前显示出年轻男性暴力事件异常高发，存在健康问题聚集现象，预期寿命缩短。健康问题可能既是暴力的原因，也是其后果，是社区层面共同的社会经济风险因素所致，还可能源于暴力高发人群无法控制的大规模社会力量。本研究的目的是深入了解格拉斯哥东部年轻成年男性暴力这一公共卫生问题。
对社会经济贫困程度不同地区的暴力及其与健康状况的关联进行生态调查。对1916名年龄在18 - 34岁的英国男性进行全国性调查，并补充了格拉斯哥东部（GE）765名男性的子样本。参与者完成了涵盖当前身体和性健康、精神症状、药物滥用、生活方式以及犯罪和暴力的问卷。
两项调查中暴力行为的5年患病率相似，但涉及武器的斗殴（调整后比值比[AOR] 3.32，95%置信区间[CI] 2.29 - 4.79）、帮派斗殴（AOR 2.30，95% CI 1.77 - 2.98）以及支持犯罪生活方式的工具性暴力在GE更为常见，那里每9名男性中就有1人曾入狱。两个样本中的暴力男性均报告身体和性健康较差，除抑郁症外的各类精神疾病发病率较高，同时存在多种未来健康状况不佳和暴力行为的高风险行为。GE地区药物和酒精依赖与暴力之间的关联不能完全由贫困来解释。
贫困城市地区的暴力是导致身心健康问题聚集以及由身心健康问题聚集所导致的众多高风险行为和生活方式因素之一。贫困部分解释了GE地区暴力水平的升高。其他因素，如药物和酒精滥用以及对暴力的大男子主义态度，在这个社会排斥社区的男性中非常普遍，也起到了作用。贫困地区可能需要多成分预防干预措施，未来需要调查多种共存的风险因素如何导致包括精神障碍、药物滥用、身体健康不佳和暴力在内的多种疾病共发情况。
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