University of Maryland, College Park, USA.
Silver Spring, MD, USA.
J Appl Gerontol. 2022 Mar;41(3):690-698. doi: 10.1177/07334648211039311. Epub 2021 Aug 17.
We examine associations between social determinants and mental health and assess how the associations vary by race/ethnicity using a large, diverse sample of older adults.
A retrospective study of 444,057 older adults responding to the Medicare Health Outcomes Survey in 2015-2017 was conducted. Using a multilevel linear regression, we examined the associations between the self-reported number of unhealthy days due to mental health and social determinants, stratified by race/ethnicity.
Health factors were most strongly associated with unhealthy days across all racial/ethnic groups. Strength of other factors varied by race/ethnicity. Social/economic factors had stronger associations among Whites, Asians, and multiracial individuals, while such factors were not significant for American Indians/Alaska Natives and Native Hawaiians/Other Pacific Islanders.
We found varying degrees of associations between social determinants and poor mental health by racial/ethnic groups. These results suggest that homogeneous interventions may not meet the mental health needs of all.
本研究使用大型多样化的老年人群体样本，考察社会决定因素与心理健康之间的关联，并评估这些关联在不同种族/民族群体中的差异。
对 2015-2017 年参与医疗保险健康结果调查的 444057 名老年患者进行回顾性研究。采用多层次线性回归分析，按种族/民族对心理健康导致的不健康天数与社会决定因素之间的关联进行分层分析。
在所有种族/民族群体中，健康因素与不健康天数的关联最强。其他因素的关联强度因种族/民族而异。社会/经济因素在白人、亚洲人和多种族个体中具有更强的关联，而对于美洲印第安人/阿拉斯加原住民和夏威夷原住民/其他太平洋岛民，这些因素则不显著。
我们发现社会决定因素与不同种族/民族群体的心理健康不良之间存在不同程度的关联。这些结果表明，同质的干预措施可能无法满足所有人的心理健康需求。
