A light of hope? Inequalities in mental health before and after the peace agreement in Colombia: a decomposition analysis.
A light of hope? Inequalities in mental health before and after the peace agreement in Colombia: a decomposition analysis.
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DOI：
10.1186/s12939-021-01381-x
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发表时间：
2021-01-19
影响因子：
4.8
通讯作者：
Moreno-Serra R
中科院分区：
文献类型：
--
作者：
León-Giraldo S;Casas G;Cuervo-Sánchez JS;González-Uribe C;Olmos A;Kreif N;Suhrcke M;Bernal O;Moreno-Serra R
本研究旨在评估2016年与哥伦比亚革命武装力量游击队签署哥伦比亚和平协议后，Meta省心理健康不平等的变化。使用由20个问题组成的经过验证的调查工具（“SRQ-20”），我们测量了从2014年签署协议前到2018年签署协议后心理健康不平等的变化。然后，我们分解不平等的变化，以确定哪些社会经济因素解释了心理健康不平等随时间的差异。我们的研究使用了2018年在哥伦比亚Meta省对1309户家庭进行的健康与和平（CONPAS）调查的信息，并回顾了2014年的信息。为了衡量不平等，我们计算了这两年的集中指数。通过瓦哈卡变化分解方法，我们分解心理健康不平等的变化，其根本因素。这种方法使我们能够解释心理健康不平等的变化和几个社会人口因素的不平等变化之间的关系。它还确定了这些因素在多大程度上有助于解释心理健康不平等的变化。从2014年到2018年，Meta的心理健康不平等减少了近一半。2018年，与2014年相比，中低社会经济水平的人口经历心理健康障碍的机会更少。心理健康差异的减少主要是由于某些社会人口变量的影响减少，例如居住在农村地区和受冲突影响的地区，在非正规部门工作，或经历境内流离失所。然而，尽管心理健康不平等现象有所减少，但这些年来总体心理健康结果却有所恶化。与冲突有关的变量在解释心理健康不平等方面的贡献减少，可能意味着冲突对心理健康的负面影响在和平协定签署后的短期内开始减少。尽管如此，冲突和其他社会经济不平等的存在仍然导致整个人口的持续不良心理健康结果。因此，公共政策的方向应该是改善这些地区的精神卫生保健服务，考虑到协议后的背景。
The present study seeks to evaluate the change in mental health inequalities in the department of Meta after the signing of Colombia’s Peace Agreement in 2016 with the FARC guerrilla group. Using a validated survey instrument composed of 20 questions (‘SRQ-20’), we measure changes in mental health inequalities from 2014, before the signing of the agreement, to 2018, after the signing. We then decompose the changes in inequalities to establish which socioeconomic factors explain differences in mental health inequalities over time. Our study uses information from the Conflicto, Salud y Paz (CONPAS) survey conducted in the department of Meta, Colombia, in 1309 households in 2018, with retrospective information for 2014. To measure inequalities, we calculate the concentration indices for both years. Through the Oaxaca change decomposition method, we disaggregate changes in mental health inequalities into its underlying factors. This method allows us to explain the relationship between changes in mental health inequalities and changes in inequalities in several sociodemographic factors. It also identifies the extent to which these factors help explain the changes in mental health inequalities. Mental health inequalities in Meta were reduced almost by half from 2014 to 2018. In 2018, the population at the lower and middle socioeconomic levels had fewer chances of experiencing mental health disorders in comparison to 2014. The reduction in mental health differences is mostly attributed to reductions in the influence of certain sociodemographic variables, such as residence in rural zones and conflict-affected territories, working in the informal sector, or experiencing internal displacement. However, even though mental health inequalities have diminished, overall mental health outcomes have worsened in these years. The reduction in the contribution of conflict-related variables for explaining mental health inequalities could mean that the negative consequences of conflict on mental health have started to diminish in the short run after the peace agreement. Nevertheless, conflict and the presence of other socioeconomic inequalities still contribute to persistent adverse mental health outcomes in the overall population. Thus, public policy should be oriented towards improving mental health care services in these territories, given the post-accord context.
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影响因子：
4.8
作者：
Morasae EK;Forouzan AS;Majdzadeh R;Asadi-Lari M;Noorbala AA;Hosseinpoor AR
通讯作者：
Hosseinpoor AR
影响因子：
168.9
作者：
de Jong, JTVM;Komproe, IH;Van Ommeren, M
通讯作者：
Van Ommeren, M
影响因子：
4.6
作者：
Ricaurte, Jorge Cuartas;Lievano Karim, Laura;Hessel, Philipp
通讯作者：
Hessel, Philipp
影响因子：
3.6
作者：
Bell V;Méndez F;Martínez C;Palma PP;Bosch M
通讯作者：
Bosch M
影响因子：
5.4
作者：
Manor, O;Matthews, S;Power, C
通讯作者：
Power, C