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社会政治变革如何与个体报告的负面生活事件数量相关:以德国统一(1989/1990 年)为例的一项基于人群的研究。

How socio-political change is associated with the number of individually reported negative life events: a population-based study using the German reunification 1989/1990 as an example.

机构信息

Department Health and Prevention, University of Greifswald, Greifswald, Germany

Department Health and Prevention, University of Greifswald, Greifswald, Germany.

出版信息

J Epidemiol Community Health. 2024 Apr 10;78(5):311-318. doi: 10.1136/jech-2023-221549.

Abstract

BACKGROUND

Socio-political change often leads to disruptions in employment and social networks, which can exacerbate health issues and increase mortality rates. These consequences are likely observed as an increase in negative life events (NLEs), serving as indicators of the broader social and health impacts. Using the German reunification in 1989/1990 as an example, this study investigates changes in reported numbers of NLEs and differences regarding sociodemographic characteristics.

METHODS

We used data from the population-based Study of Health in Pomerania (SHIP-START-0, SHIP-Life-Events and Gene-Environment Interaction in Depression; N=1932). Numbers of NLEs in different categories (work/financial, social/interpersonal, illness (own) and illness/death (others)) were measured retrospectively in 5-year intervals (1980-2004) using a semistructured interview. Pre-reunification and post-reunification changes were modelled using piecewise mixed-effects Poisson regressions with the 1990-1994 interval (reunification) as change point. Interactions with age, sex and education were examined.

RESULTS

The number of most NLE categories, except social/interpersonal NLEs, increased at reunification. Whereas work/financial NLEs slightly decreased post-reunification, illness-related NLEs continued to increase. Higher numbers of social/interpersonal NLEs were found with younger age. More illness-related NLEs were reported with older age, lower education (illness (own)) and by women (illness/death (others)). However, the majority reported no NLEs at reunification (68.2%-80.7%, varying by category).

CONCLUSION

Our findings suggest that although some individuals experience a marked increase in NLEs due to socio-political changes, many remain unaffected, emphasising the need for a differentiated understanding of these effects. This increase in NLEs may partly account for ongoing health and well-being disparities among countries with differing transformation histories.

摘要

背景

社会政治变革常常导致就业和社交网络的中断,这可能会加剧健康问题并增加死亡率。这些后果可能表现为负面生活事件 (NLE) 的增加,这些事件是更广泛的社会和健康影响的指标。本研究以 1989/1990 年德国统一为例,调查了报告的 NLE 数量的变化以及社会人口特征方面的差异。

方法

我们使用了基于人群的什未林健康研究 (SHIP-START-0、SHIP-Life-Events 和抑郁症中的基因-环境相互作用;N=1932) 的数据。使用半结构化访谈,在 5 年的间隔内(1980-2004 年),在不同类别(工作/财务、社会/人际关系、疾病(自身)和疾病/死亡(他人))中回顾性地测量 NLE 的数量。使用分段混合效应泊松回归模型,以 1990-1994 年间隔(统一)为变化点,对前统一和后统一的变化进行建模。检验了年龄、性别和教育的交互作用。

结果

除了社会/人际关系 NLE 之外,大多数 NLE 类别的数量在统一时增加。虽然工作/财务 NLE 在统一后略有减少,但与疾病相关的 NLE 仍在继续增加。年龄越小,社会/人际关系 NLE 的数量越高。年龄越大、教育程度越低(自身疾病)和女性(他人疾病/死亡)报告的与疾病相关的 NLE 越多。然而,大多数人在统一时没有报告 NLE(68.2%-80.7%,因类别而异)。

结论

我们的研究结果表明,尽管一些人由于社会政治变革而经历了 NLE 的显著增加,但许多人仍未受到影响,这强调了对这些影响进行差异化理解的必要性。这些 NLE 的增加可能部分解释了具有不同转型历史的国家之间持续存在的健康和福祉差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/608b/11041569/0defa78b9400/jech-2023-221549f01.jpg

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