Reid Rebecca A, Mavoa Suzanne, Gilmartin-Thomas Julia, Foster Sarah, Rachele Jerome N
Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
J Epidemiol Community Health. 2025 Jun 24. doi: 10.1136/jech-2025-223924.
Mental disorders contribute substantially to the global burden of disease. The neighbourhood socioeconomic environment is a key determinant of mental health, even after accounting for individual-level socioeconomic factors. However, few longitudinal studies have examined this relationship. This study examined longitudinal associations between neighbourhood socioeconomic disadvantage and psychological distress from three perspectives: overall associations, trends over time and changing neighbourhood exposures.
Data were from the Household, Income and Labour Dynamics in Australia Survey wave 7 (2007) to wave 21 (2021), a nationally representative household-based cohort study, including 109 604 observations. Mental health was assessed using the Kessler Psychological Distress Scale (K10), analysed as a continuous variable, score range 10-50. Neighbourhood socioeconomic disadvantage was measured using derived spatially and temporally consistent census-based data, analysed in quintiles. Multilevel and fixed effects linear regression models were used.
Psychological distress increased with neighbourhood socioeconomic disadvantage, with K10 scores 1.35 points higher (95% CI 1.14 to 1.55) in the most disadvantaged neighbourhoods compared with the least. However, the rate of change in distress over time did not vary by neighbourhood disadvantage. An association was observed between changes in disadvantage and changes in psychological distress for the most socioeconomically disadvantaged neighbourhoods.
The findings from nationally representative longitudinal data show that individuals living in more disadvantaged neighbourhoods consistently experienced higher psychological distress compared with those in less disadvantaged neighbourhoods. These inequalities remained stable over time, and limited evidence of change suggests that the association may reflect persistent differences between individuals living in different neighbourhoods.
精神障碍在全球疾病负担中占相当大的比例。即使在考虑了个体层面的社会经济因素之后，邻里社会经济环境仍是心理健康的关键决定因素。然而，很少有纵向研究考察这种关系。本研究从三个角度考察了邻里社会经济劣势与心理困扰之间的纵向关联：总体关联、随时间的趋势以及邻里暴露的变化。
数据来自澳大利亚家庭、收入和劳动力动态调查第7波（2007年）至第21波（2021年），这是一项具有全国代表性的基于家庭的队列研究，包括109604个观测值。使用凯斯勒心理困扰量表（K10）评估心理健康状况，将其作为连续变量进行分析，得分范围为10 - 50分。邻里社会经济劣势使用基于人口普查得出的空间和时间一致的数据进行衡量，并按五分位数进行分析。使用了多层次和固定效应线性回归模型。
心理困扰随着邻里社会经济劣势的增加而增加，最 disadvantaged 邻里的K10得分比最不 disadvantaged 邻里高1.35分（95%可信区间1.14至1.55）。然而，随着时间的推移，困扰的变化率并没有因邻里劣势而有所不同。在社会经济最 disadvantaged 的邻里中，观察到劣势变化与心理困扰变化之间存在关联。
来自具有全国代表性的纵向数据的研究结果表明，与生活在劣势较小邻里的个体相比，生活在劣势较大邻里的个体持续经历更高的心理困扰。这些不平等随着时间的推移保持稳定，有限的变化证据表明这种关联可能反映了生活在不同邻里的个体之间的持续差异。
