中国地区贫困对成人抑郁情绪的影响

Study on the effect of area deprivation on adult depressive symptoms in China

目的探索地区贫困对中国成人抑郁情绪是否存在独立于个体因素的情境效应。方法数据来源于2012年中国家庭追踪调查(CFPS),该调查是具有全国代表性的多阶段抽样调查。首先通过主成分分析方法提取县级不同维度贫困指标的第一主成分得分,采用标准化后的第一主成分得分作为地区贫困指数。采用CES-D抑郁自评量表测量成人的抑郁情绪,量表得分超过16分则认为受访者存在抑郁情绪。应用多水平Logistic回归在控制个体因素的基础上,分析地区贫困指数对成人抑郁情绪的影响。结果县级地区贫困指数取值范围为-1.91-2.84,数值越高地区贫困程度越严重。居住在最贫困20%地区的成人抑郁情绪流行率高达39.3%,而居住在最不贫困20%地区的成人抑郁情绪流行率为20.5%。多水平Logistic回归分析结果显示,在控制了个体社会经济因素后,县级地区贫困指数每增加一个单位,成人发生抑郁情绪的概率依然不断增加(OR=1.189,P <0.001)。结论地区贫困对成人抑郁情绪具有独立的情境效应,改善人群抑郁情绪不仅仅需要采取基于个体的健康促进策略,还需要着眼于地区的社会经济地位,采用基于地区的健康促进策略。

Objective To explore whether area deprivation has an independent effect on adult depressive symptoms in China.Methods The data were obtained from the 2012 China Family Panel Survey(CFPS),a nationally representative survey with multi-staged sampling design.The principal component analysis was used to extract the first principal component of county-level deprivation indicators,and the standardized first principal component was defined as the county-level area deprivation index(ADI).Center for Epidemiologic Studies Depression Scale(CES-D) was used to measure depressive symptoms of adults if the CES-D score reached16 and above.Multi-level logistic regression was used to quantify the effect of county-level area deprivation on adult depressive symptom after controlling on individual demographic and socioeconomic factors.Results Thearea deprivation index ranged from -1.91 to 2.84,which meant the area was more deprived with the area deprivation index increasing.The prevalence of depressive symptoms in adults was 39.3% in the most deprived 20% counties,while only 20.5% in the least deprived 20% counties.Multi-level logistic regression analysis showed that after controlling individual-level demographic and socioeconomic factors,the probability of adult having depressive symptom increased with the area deprivation index(OR=1.189,P <0.001).Conclusion Area deprivation has an independent contextual effect on adult depressive symptoms.Promoting mental health of the population requires not only individual-based health promotion strategies but also area-based health promotion strategies.