Faruque Farhana, Shah Gulzar H, Bohler Robert M
Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA.
Eur J Investig Health Psychol Educ. 2025 May 17;15(5):87. doi: 10.3390/ejihpe15050087.
Social determinants of health (SDoH) are considered significant determinants of mental health. This study examines the association between SDoH and mental health status in the United States. We analyzed 2023 Behavioral Risk Factor Surveillance System (BRFSS) data from 183,318 U.S. adults using multinomial logistic regression. Several SDoH were significantly linked to the frequency of poor mental health days. After adjusting for all covariates, individuals facing difficulty paying utility bills had lower odds of experiencing episodic (vs. chronic) poor mental health (AOR = 0.47, = 0.031). Transportation challenges were associated with lower odds of episodic distress rather than chronic mental health issues (AOR = 0.35, = 0.026). Individuals who were unable to afford a doctor or who experienced employment loss had significantly lower odds of reporting no poor mental health days compared to reporting chronic poor mental health, with adjusted odds ratios of 0.37 and 0.84, respectively. Non-Hispanic Whites and males were more likely to report chronic poor mental health. Policies that prioritize economic stability and job security, reliable transportation, and equal access to education and healthcare are crucial for promoting mental health equity across diverse populations.
健康的社会决定因素（SDoH）被认为是心理健康的重要决定因素。本研究考察了美国SDoH与心理健康状况之间的关联。我们使用多项逻辑回归分析了来自183,318名美国成年人的2023年行为风险因素监测系统（BRFSS）数据。若干SDoH与心理健康状况不佳天数的频率显著相关。在对所有协变量进行调整后，面临支付水电费困难的个体出现间歇性（而非慢性）心理健康状况不佳的几率较低（调整后的比值比[AOR]=0.47，P=0.031）。交通挑战与间歇性困扰几率较低相关，而非与慢性心理健康问题相关（AOR=0.35，P=0.026）。与报告慢性心理健康状况不佳相比，无力负担看医生费用或经历失业的个体报告无心理健康状况不佳天数的几率显著较低，调整后的比值比分别为0.37和0.84。非西班牙裔白人及男性更有可能报告慢性心理健康状况不佳。将经济稳定和工作保障、可靠交通以及平等获得教育和医疗保健作为优先事项的政策对于促进不同人群的心理健康公平至关重要。
