Research Institute of Child Development and Education, University of Amsterdam, the Netherlands.
Research Institute of Child Development and Education, University of Amsterdam, the Netherlands.
Public Health. 2024 Nov;236:347-353. doi: 10.1016/j.puhe.2024.09.013. Epub 2024 Sep 19.
The enormous societal and individual consequences of mental health disorders and detrimental health behaviours in the general population are of paramount concern. Many argue that 'prevention is the best cure', pushing for the implementation of early (preventive) interventions. Key questions regarding early interventions include which population segment to target for screenings and what information these screenings should focus on. In line with previous efforts, this study aimed to identify which population segment holds the majority (≥ 80 %) of different economically costly outcomes in society, and whether child abuse before the age of 16 years predicts being part of that population segment.
Epidemiological cohort study.
This study used the Netherlands Mental Health Survey and Incidence Study-2, a Dutch epidemiological cohort study including 6646 adults aged 18-64 years at baseline, spanning four timepoints from 2007 to 2018. Cumulative distributions were computed to identify high-cost population segments of economically costly outcomes in adulthood (i.e., mental and physical health [behaviours], unemployment and work absenteeism). Child abuse was examined as a potential predictor of these segments and the risk of multiple high-cost population segment membership was investigated by conducting Poisson regressions.
A 20 % population segment carried between 42 % and 100 % of economically costly outcomes. Being exposed to more child abuse predicted being in a high-cost population segment, albeit with small effect sizes. Being exposed to more child abuse also predicted belonging to multiple high-cost population segments across different economically costly outcomes.
The study findings have implications for policy makers. Emphasis should be placed on prevention aimed at identifying potential members of multiple high-cost population segments.
精神健康障碍和普通人群中有害健康行为所带来的巨大社会和个人后果是首要关注的问题。许多人认为“预防是最好的治疗方法”，并推动实施早期（预防）干预措施。早期干预的关键问题包括针对哪些人群进行筛查，以及这些筛查应重点关注哪些信息。本研究旨在确定哪些人群在社会中拥有大多数（≥80%）不同的经济成本结果，并探讨 16 岁以前的儿童虐待是否预示着他们属于该人群。
流行病学队列研究。
本研究使用了荷兰心理健康调查和发病率研究-2，这是一项荷兰的流行病学队列研究，包括 6646 名年龄在 18-64 岁的成年人，在 2007 年至 2018 年期间进行了四次随访。通过计算累积分布，确定了成年期经济成本结果（即精神和身体健康[行为]、失业和工作缺勤）的高成本人群。将儿童虐待作为这些人群的潜在预测指标进行了研究，并通过进行泊松回归来探讨了多种高成本人群的风险。
一个 20%的人群携带了 42%-100%的经济成本结果。暴露于更多的儿童虐待与处于高成本人群相关，尽管效应大小较小。暴露于更多的儿童虐待也预示着在不同的经济成本结果中属于多个高成本人群。
本研究结果对政策制定者具有启示意义。应将重点放在旨在识别多个高成本人群潜在成员的预防措施上。
