Asnake Angwach Abrham, Fente Bezawit Melak, Seifu Beminate Lemma, Asebe Hiwot Altaye, Melkam Mamaru, Bezie Meklit Melaku, Negussie Yohannes Mekuria, Asmare Zufan Alamrie
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Department of General Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia.
Heliyon. 2024 Nov 22;10(23):e40610. doi: 10.1016/j.heliyon.2024.e40610. eCollection 2024 Dec 15.
Mental health problems, particularly anxiety and depression, are indeed among the leading health challenges worldwide, affecting individuals across all age groups and geographic locations. The relationship between mental health and socioeconomic factors, including household wealth status, is well-documented. However, there are currently no studies demonstrating a causal relationship between household wealth and common mental disorders, such as anxiety and depression. Therefore, this study aimed to assess the effect of household wealth status on anxiety and depression through Propensity Score Matching analysis (PSM) analysis.
This study used the recent 2022 Nepal Demographic and Health Survey (NDHS). A weighted sample of 7411 reproductive-age (aged 15-49 years) women who were interviewed for mental health conditions were included in this study. Anxiety and depression were the dependent variables of this study. The NDHS utilized the Generalized Anxiety Disorder 7-item scale (GAD-7) to assess levels of anxiety among participants and the Patient Health Questionnaire 9 (PHQ-9) to evaluate depression. PSM analysis was employed to examine the causal connection between household wealth and women's anxiety and depression by controlling for confounding variables.
The average treatment effects (ATE) of non-poor household status on anxiety and depression were -0.015 and -0.052 respectively, indicating that non-poor household status reduces women's anxiety and depression. It implies the difference in risks of anxiety and depression that would be observed if everyone in the population were from non-poor households, versus if everyone in the population were from poor households were 1.5 % and 5.2 % respectively. The average treatment effect on treated (ATT) result showed that women from non-poor wealth status households reduced the risk of anxiety and depression by 1.1 % and 9.2 % respectively among treated groups.
This study evidenced that causal relationship between household wealth status and common mental health conditions as such anxiety and depression. This suggests, it is better to focus on improving the wealth status of households to enhance the mental health of reproductive-age women. By understanding the multidimensional aspects of poverty and their links to mental health, stakeholders can create more effective strategies to support affected individuals and communities. This can contribute to breaking the cycle of poverty and improving overall well-being.
心理健康问题，尤其是焦虑和抑郁，确实是全球主要的健康挑战之一，影响着所有年龄组和地理位置的人群。心理健康与社会经济因素之间的关系，包括家庭财富状况，已有充分记录。然而，目前尚无研究证明家庭财富与焦虑和抑郁等常见精神障碍之间存在因果关系。因此，本研究旨在通过倾向得分匹配分析（PSM）评估家庭财富状况对焦虑和抑郁的影响。
本研究使用了最近的2022年尼泊尔人口与健康调查（NDHS）。本研究纳入了7411名接受心理健康状况访谈的育龄（15 - 49岁）女性的加权样本。焦虑和抑郁是本研究的因变量。NDHS使用广泛性焦虑障碍7项量表（GAD - 7）评估参与者的焦虑水平，并使用患者健康问卷9（PHQ - 9）评估抑郁。通过控制混杂变量，采用PSM分析来检验家庭财富与女性焦虑和抑郁之间的因果关系。
非贫困家庭状况对焦虑和抑郁的平均治疗效果（ATE）分别为 - 0.015和 - 0.052，表明非贫困家庭状况可减轻女性的焦虑和抑郁。这意味着，如果人群中的每个人都来自非贫困家庭，与如果每个人都来自贫困家庭相比，观察到的焦虑和抑郁风险差异分别为1.5%和5.2%。对治疗组的平均治疗效果（ATT）结果表明，非贫困家庭财富状况的女性在治疗组中分别将焦虑和抑郁风险降低了1.1%和9.2%。
本研究证明了家庭财富状况与焦虑和抑郁等常见心理健康状况之间的因果关系。这表明，更好的做法是专注于改善家庭财富状况，以提高育龄女性的心理健康。通过了解贫困的多维度方面及其与心理健康的联系，利益相关者可以制定更有效的策略来支持受影响的个人和社区。这有助于打破贫困循环，提高整体幸福感。
