Department of Paediatrics, The University of Melbourne, Parkville 3052, Australia.
Department of Social Work, The University of Melbourne, Parkville 3010, Australia.
Int J Environ Res Public Health. 2023 Jan 17;20(3):1711. doi: 10.3390/ijerph20031711.
People who experience social marginalization and vulnerability have uniquely complex health needs and are at risk of poor health outcomes. Regression analyses using longitudinal data from a cross-national, population-based sample of young adults participating in the International Youth Development Study, tested associations between social marginalization and vulnerabilities and physical health, mental health, and substance use outcomes. Participants from Victoria, Australia, and Washington State in the US were surveyed at ages 25 (2014) and 29 years (2018; = 1944; 46.7% male). A history of adverse childhood experiences (ACEs), LGBT identity, financial insecurity, and justice system involvement at age 25 predicted poor health outcomes at age 28, including lower perceived health status, risk for chronic illness, depression and anxiety symptoms, and diagnosed mental health/substance use disorders. Tests of model equivalence across states showed that a history of ACEs was more strongly related to health status and serious injury at age 28 and justice system involvement at age 25 was more strongly related to age 28 serious injury in Victoria than in Washington State. Findings strengthen the case for future population-based research identifying life-course interventions and state policies for reducing poor health and improving health equity among members of socially marginalized groups.
经历社会边缘化和脆弱性的人有着独特而复杂的健康需求，他们面临着健康状况不佳的风险。本研究使用来自参与国际青年发展研究的跨国、基于人群的青年成年人的纵向数据进行回归分析，检验了社会边缘化和脆弱性与身体健康、心理健康和物质使用结果之间的关联。来自澳大利亚维多利亚州和美国华盛顿州的参与者在 25 岁（2014 年）和 29 岁（2018 年）接受了调查；=1944；46.7%为男性）。25 岁时的不良童年经历（ACEs）、LGBT 身份、经济不安全和司法系统参与史预测了 28 岁时的健康结果不佳，包括较低的健康感知、慢性疾病风险、抑郁和焦虑症状以及诊断出的心理健康/物质使用障碍。在各州的模型等效性检验中，发现 ACEs 史与 28 岁时的健康状况和严重伤害的相关性更强，而 25 岁时的司法系统参与与 28 岁时的严重伤害的相关性更强在维多利亚州比在华盛顿州。这些发现为未来基于人群的研究提供了依据，这些研究旨在确定针对社会边缘化群体成员的生活过程干预措施和州政策，以减少不良健康状况并改善健康公平。
