Carrere Juli, Vásquez-Vera Hugo, Pérez-Luna Alba, Novoa Ana M, Borrell Carme
Agència de Salut Pública de Barcelona, Pl. de Lesseps, 1, 08023, Barcelona, Spain.
Departament de Ciències Experimentals i de la Salut, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain.
J Urban Health. 2022 Apr;99(2):268-276. doi: 10.1007/s11524-022-00619-5. Epub 2022 Mar 18.
While the adverse effects of housing insecurity on mental health are known, much less is known about the modifiers underlying these effects. The aim of this study was to analyze the mental health of people with housing insecurity by housing tenure and considering the coexistence of other life insecurities (energy poverty and food insecurity). We conducted a cross-sectional study through a survey performed in all people attending the Platform for People Affected by Mortgages or the Alliance against Energy Poverty of Barcelona for the first time between June 2017 and December 2019 and who reported housing insecurity. The dependent variables were the risk of poor mental health, self-reported anxiety and/or depression, and the use of psychotropic drugs. We fitted age-adjusted robust Poisson regression models for each dependent variable and estimated adjusted prevalence ratios (aPR). The study included 256 women and 104 men. The prevalence of poor mental health was 89% in women and 85.3% in men, which was much higher than that in the general population of Barcelona (19.5% and 14.5%, respectively). Among women, mental health was worse in those living in a squat (aPR 1.16; 95% CI: 1.02-1.31) and in those with food insecurity (aPR 1.11; 95% CI: 1.01-1.21). The number of coexisting insecurities showed a gradient effect (3 insecurities: aPR 1.21; 95% CI: 1.01-1.45). Among men, the results showed no clear pattern. Poor mental health was highly prevalent in people with housing insecurity and was exacerbated by the coexistence of life insecurities. Public policymakers should consider the complexity of persons with housing insecurity.
虽然住房不安全对心理健康的不利影响是已知的，但对这些影响背后的调节因素却知之甚少。本研究的目的是按住房保有 tenure 类型分析住房不安全人群的心理健康状况，并考虑其他生活不安全因素（能源贫困和粮食不安全）的共存情况。我们通过对2017年6月至2019年12月期间首次参加受抵押贷款影响人群平台或巴塞罗那能源贫困联盟且报告住房不安全的所有人进行调查，开展了一项横断面研究。因变量为心理健康状况不佳的风险、自我报告的焦虑和/或抑郁以及精神药物的使用情况。我们针对每个因变量拟合了年龄调整后的稳健泊松回归模型，并估计了调整后的患病率比（aPR）。该研究纳入了256名女性和104名男性。女性心理健康状况不佳的患病率为89%，男性为85.3%，远高于巴塞罗那普通人群（分别为19.5%和14.5%）。在女性中，居住在 squat 的人群（aPR 1.16；95%置信区间：1.02 - 1.31）和存在粮食不安全的人群（aPR 1.11；95%置信区间：1.01 - 1.21）心理健康状况更差。共存不安全因素的数量呈现梯度效应（3种不安全因素：aPR 1.21；95%置信区间：1.01 - 1.45）。在男性中则未呈现出明确模式。住房不安全人群中心理健康状况不佳的情况非常普遍，且生活不安全因素的共存会加剧这种情况。公共政策制定者应考虑住房不安全人群的复杂性。
