收入不平等与中国成年人的抑郁症状：一项准实验研究。

Income inequality and depressive symptoms among Chinese adults: a quasi-experimental study.

机构信息

State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China.

出版信息

Public Health. 2024 Jan;226:58-65. doi: 10.1016/j.puhe.2023.10.042. Epub 2023 Nov 25.

DOI:10.1016/j.puhe.2023.10.042

PMID:38007842

Abstract

OBJECTIVE

There is a lack of causal evidence on the impact of income inequality on depressive symptoms. The impact of China's Targeted Poverty Alleviation (TPA) policy on depressive symptoms is also unclear. Using a quasi-experimental design, this study aims to investigate the causal effects of TPA and income inequality on depressive symptoms among Chinese adults.

STUDY DESIGN

This is a population-based study.

METHODS

Three waves (2012, 2016, and 2018) of the China Family Panel Studies (CFPS), a nationally representative sample of China, were included in this study. We performed difference-in-difference (DID) models to assess the effect of TPA and income inequality on depressive symptoms. We further conducted the mixed effect models to examine the impact of income inequality on depressive symptoms. The study considered a range of spatial factors and spatial splines to address spatial autocorrelations.

RESULTS

This study included valid measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D-8] score) from 14,442 adults of CFPS. The DID results indicated that at the provincial level, the CES-D-8 score of the TPA treatment group was on average 0.570 (95% confidence interval [CI]: 0.358-0.783) less than the control group. Furthermore, a 0.1 increase in Gini index would lead to a 0.256 (95% CI: 0.064-0.448) increase in CES-D-8 score. The mixed effect model showed that income inequality was a risk factor for depressive symptoms at the provincial level (excess risk = 5.602% [95% CI: 3.047%-8.219%]).

CONCLUSIONS

Our findings suggest that income inequality adversely affects mental health, but China's Targeted Poverty Alleviation improves the mental health of the Chinese population.

摘要

目的

关于收入不平等对抑郁症状的影响，缺乏因果证据。中国精准扶贫政策对抑郁症状的影响也不清楚。本研究采用准实验设计，旨在探讨精准扶贫和收入不平等对中国成年人抑郁症状的因果影响。

研究设计

这是一项基于人群的研究。

方法

本研究纳入了全国代表性样本中国家庭追踪调查（CFPS）的三个时间点（2012 年、2016 年和 2018 年）。我们采用双重差分（DID）模型评估精准扶贫和收入不平等对抑郁症状的影响。我们进一步进行了混合效应模型，以检验收入不平等对抑郁症状的影响。该研究考虑了一系列空间因素和空间样条，以解决空间自相关问题。

结果

本研究共纳入了来自 CFPS 的 14442 名成年人的有效抑郁症状（流行病学研究中心抑郁量表[CES-D-8]评分）测量值。DID 结果表明，在省级层面上，精准扶贫治疗组的 CES-D-8 评分平均比对照组低 0.570（95%置信区间[CI]：0.358-0.783）。此外，基尼指数增加 0.1，CES-D-8 评分将增加 0.256（95%CI：0.064-0.448）。混合效应模型显示，收入不平等是省级层面抑郁症状的一个风险因素（超额风险=5.602%[95%CI：3.047%-8.219%]）。