Brown Heather, Gao Ni, Song Wei
Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster LA1 4AT, UK.
Centre for Health Economics, York University, Heslington, York, YO10 5DD, UK.
Soc Sci Med. 2024 Jul;353:117068. doi: 10.1016/j.socscimed.2024.117068. Epub 2024 Jun 24.
Young people's mental health globally has been in decline. Because of their low perceived need, young people's services tend to be the first cut when budgets are reduced. There is a lack of evidence on how a reduction in services and opportunities for young people is associated with their mental health. Additionally, how this may be magnified by place and the assets and challenges of place. The aim of this study is to explore trends in young people's mental health measured by GHQ-12 over time in the twelve regions of the UK. We estimated an interrupted time series model using 2010 as a break point from which there was a shift in government policy to a prolonged period of large reductions in central government funding. Repeated cross-sectional data on young people aged 16-25 is used from the British Household Panel Survey and its successor survey UK Household Longitudinal Survey. Results showed a statistically significant reduction in mental health for young people living in the North East, Wales, and the East of England. The North East was the region with the largest reduction in funding and saw the greatest reduction in young people's mental health. Next, we look at how reductions in local government expenditure related to services for children and young people: children's social services, education, transportation, and culture; explain the observed decline in mental health. We employ a Blinder-Oaxaca Decomposition approach comparing young people's mental health between 2011 and 2017. Results show a marginally statistically significant decrease in young people's mental health over this time. Unobserved factors related to transport spending and children's social services explain some of this gap. Area level factors such as deprivation, infrastructure, and existing assets need to be considered when distributing funding for young people's services to avoid exacerbating regional inequalities in mental health.
全球年轻人的心理健康状况一直在下降。由于他们自身感知到的需求较低，在预算削减时，年轻人的服务往往是最先被削减的对象。目前缺乏证据表明，针对年轻人的服务和机会减少与他们的心理健康之间存在何种关联。此外，这种情况如何会因地区以及地区的资产和挑战而被放大。本研究的目的是探讨在英国的12个地区，随着时间推移，用一般健康问卷-12（GHQ-12）衡量的年轻人心理健康趋势。我们估计了一个中断时间序列模型，将2010年作为一个断点，自该时间点起政府政策发生转变，进入中央政府资金大幅削减的长期阶段。使用了英国家庭追踪调查及其后续调查英国家庭纵向调查中16至25岁年轻人的重复横截面数据。结果显示，生活在东北部、威尔士和英格兰东部的年轻人心理健康状况出现了具有统计学意义的下降。东北部是资金削减幅度最大的地区，年轻人心理健康状况下降幅度也最大。接下来，我们研究地方政府在儿童和年轻人服务方面的支出削减情况：儿童社会服务、教育、交通和文化；如何解释所观察到的心理健康下降情况。我们采用布林德-奥萨卡分解方法，比较了2011年至2017年期间年轻人的心理健康状况。结果显示，在此期间年轻人的心理健康状况有略微具有统计学意义的下降。与交通支出和儿童社会服务相关的未观察到的因素解释了部分这一差距。在分配年轻人服务资金时，需要考虑诸如贫困、基础设施和现有资产等地区层面的因素，以避免加剧心理健康方面的地区不平等。
Zotero 插件