National Centre for Register-Based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark; Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
National Centre for Register-Based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark; Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark.
Lancet Public Health. 2023 Feb;8(2):e99-e108. doi: 10.1016/S2468-2667(22)00292-4.
A socioeconomically disadvantaged childhood has been associated with elevated self-harm and violent criminality risks during adolescence and young adulthood. However, whether these risks are modified by a neighbourhood's socioeconomic profile is unclear. The aim of our study was to compare risks among disadvantaged young people residing in deprived areas versus risks among similarly disadvantaged individuals residing in affluent areas.
We did a national cohort study, using Danish interlinked national registers, from which we delineated a longitudinal cohort of people born in Denmark between Jan 1, 1981, and Dec 31, 2001, with two Danish-born parents, who were alive and residing in the country when they were aged 15 years, who were followed up for a hospital-treated self-harm episode or violent crime conviction. A neighbourhood affluence indicator was derived based on nationwide income quartiles, with parental income and educational attainment indicating the socioeconomic position of each cohort member's family. Bayesian multilevel survival analyses were done to examine the moderating influences of neighbourhood affluence on associations between family socioeconomic position and sex-specific risks for the two adverse outcomes.
1 084 047 cohort members were followed up for 12·8 million person-years in aggregate. Individuals of a low socioeconomic position residing in deprived neighbourhoods had a higher incidence of both self-harm and violent criminality compared with equivalently disadvantaged peers residing in affluent areas. Women from a low-income background residing in affluent areas had, on average, 95 (highest density interval 76-118) fewer self-harm episodes and 25 (15-41) fewer violent crime convictions per 10 000 person-years compared with women of an equally low income residing in deprived areas, whereas men of a low income residing in affluent areas had 61 (39-81) fewer self-harm episodes and 88 (56-191) fewer violent crime convictions per 10 000 person-years than men of a low income residing in deprived areas.
Even in a high-income European country with comprehensive social welfare and low levels of poverty and inequality, individuals residing in affluent neighbourhoods have lower risks of self-harm and violent criminality compared with individuals residing in deprived neighbourhoods. More research is needed to explore the potential of neighbourhood policies and interventions to reduce the harmful effects of growing up in socioeconomically deprived circumstances on later risk of self-harm and violent crime convictions.
European Research Council, Lundbeck Foundation Initiative for Integrative Psychiatric Research, and BERTHA, the Danish Big Data Centre for Environment and Health funded by the Novo Nordisk Foundation Challenge Programme.
社会经济地位较低的童年与青少年和成年早期的自我伤害和暴力犯罪风险升高有关。然而，这种风险是否会受到邻里社会经济状况的影响尚不清楚。我们的研究目的是比较居住在贫困地区的弱势青年和居住在富裕地区的弱势个体之间的风险。
我们进行了一项全国性队列研究，使用丹麦相互关联的全国登记处，从中划定了 1981 年 1 月 1 日至 2001 年 12 月 31 日期间在丹麦出生的父母双方均为丹麦人的纵向队列，当他们 15 岁时，这些人还活着并居住在丹麦，他们被跟踪调查是否有医院治疗的自伤事件或暴力犯罪定罪。根据全国收入四分位数得出了一个邻里富裕指标，父母的收入和教育程度表明了每个队列成员家庭的社会经济地位。采用贝叶斯多层次生存分析来检验邻里富裕对家庭社会经济地位与两种不良结果的性别特定风险之间关联的调节作用。
1084047 名队列成员共随访了 1280 万人年。与居住在富裕地区的同等贫困同龄人相比，居住在贫困社区的社会经济地位较低的个体发生自我伤害和暴力犯罪的几率更高。与收入同样较低的居住在贫困地区的女性相比，居住在富裕地区的低收入背景的女性平均每年每 10000 人减少 95 次（最高密度间隔为 76-118 次）自我伤害发作和 25 次（15-41 次）暴力犯罪定罪，而居住在富裕地区的低收入男性每年每 10000 人减少 61 次（39-81 次）自我伤害发作和 88 次（56-191 次）暴力犯罪定罪，而收入同样较低的居住在贫困地区的男性。
即使在一个高收入的欧洲国家，那里有全面的社会福利，贫困和不平等程度较低，居住在富裕社区的人也比居住在贫困社区的人自我伤害和暴力犯罪的风险更低。需要进一步研究探索邻里政策和干预措施的潜力，以减少在社会经济上处于不利地位的环境中成长对后来自我伤害和暴力犯罪定罪风险的有害影响。
欧洲研究理事会、Lundbeck 基金会综合精神病学研究倡议以及由 Novo Nordisk 基金会挑战计划资助的丹麦大数据环境与健康中心 BERTHA。
