Relative wealth, subjective social status, and their associations with depression: Cross-sectional, population-based study in rural Uganda.
Relative wealth, subjective social status, and their associations with depression: Cross-sectional, population-based study in rural Uganda.
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相对财富、主观社会地位及其与抑郁症的关联：乌干达农村地区基于人口的横断面研究。
DOI：
10.1016/j.ssmph.2019.100448
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Tsai,AlexanderC
中科院分区：
文献类型：
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作者：
Smith,MeghanL;Kakuhikire,Bernard;Baguma,Charles;Rasmussen,JustinD;Perkins,JessicaM;Cooper-Vince,Christine;Venkataramani,AtheendarS;Ashaba,Scholastic;Bangsberg,DavidR;Tsai,AlexanderC
抑郁症是全球残疾的主要原因，并且已被发现与社会经济地位（SES）一致相关。相对剥夺假说提出，社会经济地位与健康的联系机制之一涉及社会比较，这表明相对社会经济地位而不是绝对社会经济地位是决定健康状况的首要因素。使用来自乌干达西南部农村的1，620名参与者的全人群样本的数据，我们估计了客观和主观相对财富与可能的抑郁症之间的独立关联，通过霍普金斯症状量表（HSCLD）的抑郁子量表进行测量。客观相对财富是通过基于住房特征和家庭财产信息的资产指数来衡量的，该指数用于将研究参与者的相对家庭资产财富分为五分之一（每个村庄内）。主观相对财富是通过一个单一的问题来衡量的，这个问题要求参与者在5分制的李克特量表上对他们的财富进行评级，相对于他们村庄的其他人。在人群中，460名研究参与者（28.4%）对可能的抑郁症筛查呈阳性。使用具有聚类稳健误差方差的泊松回归，我们发现主观相对财富与可能的抑郁相关，调整了客观相对财富和其他协变量（调整后的相对风险[aRR]比较最低与最高水平的主观相对财富= 1.90，95%置信区间[CI]：1.18，3.06）。客观相对财富与可能的抑郁无关（aRR比较客观相对财富的最低与最高五分位数= 1.09，95% CI：0.77，1.55）。这些结果表明，在这种情况下，主观相对财富是一个更强的心理健康状况的相关性相比，客观相对财富。我们的研究结果可能与相对剥夺假说一致，但需要更多的研究来解释财富的相对差异是如何（准确或不准确）感知的，并阐明这些感知对健康结果的影响。
Depression is a leading cause of disability worldwide, and has been found to be a consistent correlate of socioeconomic status (SES). The relative deprivation hypothesis proposes that one mechanism linking SES to health involves social comparisons, suggesting that relative SES rather than absolute SES is of primary importance in determining health status. Using data from a whole-population sample of 1,620 participants residing in rural southwestern Uganda, we estimated the independent associations between objective and subjective relative wealth and probable depression, as measured by the depression subscale of the Hopkins Symptom Checklist (HSCLD). Objective relative wealth was measured by an asset index based on information about housing characteristics and household possessions, which was used to rank study participants into quintiles (within each village) of relative household asset wealth. Subjective relative wealth was measured by a single question asking participants to rate their wealth, on a 5-point Likert scale, relative to others in their village. Within the population, 460 study participants (28.4%) screened positive for probable depression. Using Poisson regression with cluster-robust error variance, we found that subjective relative wealth was associated with probable depression, adjusting for objective relative wealth and other covariates (adjusted relative risk [aRR] comparing lowest vs. highest level of subjective relative wealth = 1.90, 95% confidence interval [CI]: 1.18, 3.06). Objective relative wealth was not associated with probable depression (aRR comparing lowest vs. highest quintile of objective relative wealth = 1.09, 95% CI: 0.77, 1.55). These results suggest that, in this context, subjective relative wealth is a stronger correlate of mental health status compared with objective relative wealth. Our findings are potentially consistent with the relative deprivation hypothesis, but more research is needed to explain how relative differences in wealth are (accurately or inaccurately) perceived and to elucidate the implications of these perceptions for health outcomes.