Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
Principal Research Fellow, Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
J Affect Disord. 2021 Dec 1;295:390-396. doi: 10.1016/j.jad.2021.08.037. Epub 2021 Aug 27.
The association between psychological distress and area of residence has been extensively discussed and debated. However, the focus has been largely on men and area of residence is often dichotomised to urban and rural. The aim of this study is to examine the association between psychological distress and area of residence in young Australian women using a broader geographical measure.
Data were from 8961 women aged 19-26 in the 1989-95 cohort of the Australian Longitudinal Study on Women's Health in 2015. The association between area of residence (measured by the Modified Monash Model) and psychological distress (measured by the K10), adjusted for demographic factors, indicators of socioeconomic position and health behaviour characteristics, was analysed using logistic regression.
Women in regional centres had lower odds of high to very high psychological distress compared with women in metropolitan areas (adjusted odds ratio 0.73 (95% confidence interval 0.60-0.89)). Women living in large rural towns, medium rural towns and small rural towns/remote/very remote communities had similar levels of psychological distress as women living in metropolitan areas.
ALSWH uses self-report questionnaires which may introduce potential self-report bias. The small sample size in areas outside of metropolitan areas resulted in the need to collapse small rural towns, remote communities and very remote communities into one category.
The subtle regional differences in levels of psychological distress in young women in Australia highlights the importance of the link between health and where people live and suggests further work is required to understand the regional differences and encourage location specific mental health services.
心理困扰与居住区域之间的关系已被广泛讨论和争论。然而，研究重点主要集中在男性身上，且居住区域通常分为城市和农村。本研究旨在使用更广泛的地理衡量标准，研究年轻澳大利亚女性的心理困扰与居住区域之间的关系。
数据来自于 1989-1995 年澳大利亚妇女健康纵向研究中 19-26 岁的 8961 名女性，于 2015 年进行分析。使用逻辑回归分析居住区域（采用改良莫纳什模型衡量）与心理困扰（采用 K10 量表衡量）之间的关联，同时调整了人口统计学因素、社会经济地位指标和健康行为特征。
与居住在大都市的女性相比，居住在区域中心的女性具有较低的高至极高心理困扰的几率（调整后的比值比 0.73（95%置信区间 0.60-0.89））。居住在大型农村城镇、中型农村城镇和小型农村城镇/偏远/非常偏远社区的女性与居住在大都市的女性具有相似水平的心理困扰。
ALSWH 使用自我报告问卷，这可能会引入潜在的自我报告偏倚。大都市以外地区的样本量较小，导致需要将小型农村城镇、偏远社区和非常偏远社区合并为一个类别。
澳大利亚年轻女性心理困扰水平的细微区域差异突显了健康与人们居住地点之间的联系的重要性，并表明需要进一步研究以了解区域差异并鼓励针对特定地点的心理健康服务。
