Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 2023 May;58(5):735-744. doi: 10.1007/s00127-023-02427-x. Epub 2023 Feb 9.
Existing evidence on the mental health consequences of disadvantaged areas uses cross-sectional or longitudinal studies with short observation periods. The objective of this research was to investigate this association over a 69-year period.
Data were obtained from the MRC National Survey of Health and Development (NSHD; the British 1946 birth cohort), which consisted of 2125 participants at 69 years. We assessed longitudinal associations between area disadvantage and mental health symptoms at adolescence and adulthood with use of multilevel modelling framework.
After adjustment for father's social class, for each one percentage increase in area disadvantage at age 4, there was a 0.02 (95% CI 0.001, 0.04) mean increase in the total score of the neuroticism scale at age 13-15. After adjustment for father's social class, adult socio-economic position, cognitive ability and educational attainment, a one percentage increase in change score of area disadvantage between age 4 and 26 was associated with a mean increase in the total Psychiatric Symptom Frequency score (MD 0.06; 95% CI 0.007, 0.11). Similar associations were observed with change scores between ages 4, 53, 60 and total General Health Questionnaire-28 score at age 53 (MD 0.05; 95% CI 0.01, 0.11) and 60-64 (MD 0.06; 95% CI 0.009, 0.11).
Cohort members who experienced increasing area disadvantage from childhood were at increased risk of poor mental health over the life course. Population-wide interventions aiming at improving social and physical aspects of the early neighbourhood environment could reduce the socio-economic burden of poor mental health.
现有关于不利地区对心理健康影响的证据使用的是横断面或纵向研究，观察期较短。本研究的目的是在 69 年的时间内研究这种关联。
数据来自 MRC 国家健康与发展调查（NSHD；英国 1946 年出生队列），其中包括 2125 名 69 岁的参与者。我们使用多层次建模框架评估了青少年和成年时期的区域劣势与心理健康症状之间的纵向关联。
在调整了父亲的社会阶层后，每增加 1%的区域劣势，在 13-15 岁时，神经质量表的总分就会增加 0.02（95%CI 0.001，0.04）。在调整了父亲的社会阶层、成年社会经济地位、认知能力和教育程度后，4 岁至 26 岁之间的区域劣势变化分数每增加 1%，与精神症状频率总得分的平均增加相关（MD 0.06；95%CI 0.007，0.11）。在 4 岁、53 岁、60 岁和 53 岁的一般健康问卷-28 总分之间的变化分数以及在 60-64 岁之间的变化分数也观察到类似的关联（MD 0.05；95%CI 0.01，0.11）和 60-64 岁（MD 0.06；95%CI 0.009，0.11）。
从儿童时期开始经历区域劣势增加的队列成员在整个生命过程中面临更高的心理健康不良风险。旨在改善早期邻里环境的社会和物质方面的全人群干预措施可以减轻贫困心理健康的社会经济负担。
