Income inequality among American states and the conditional risk of post-traumatic stress disorder.
Income inequality among American states and the conditional risk of post-traumatic stress disorder.
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DOI：
10.1007/s00127-017-1413-x
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发表时间：
2017-09
影响因子：
4.4
通讯作者：
Gilman SE
中科院分区：
文献类型：
--
作者：
Pabayo R;Fuller D;Goldstein RB;Kawachi I;Gilman SE
创伤性事件后的创伤后精神障碍（PTSD）易感性可以受到个体水平和环境因素的影响。社会和经济环境的特点可能会增加创伤性事件发生后患PTSD的几率。收入不平等已被确定为潜在的环境决定因素之一。本研究的目的是探讨州一级收入不平等与创伤成人PTSD之间的关系。我们使用的数据来自全国酒精及相关疾病流行病学调查（n=34,653）。在基线（2001-2002年）和随访（2004-2005年）进行结构化诊断访谈。在研究的3年随访期间，通过调整个人和州的协变量，采用加权多级逻辑回归来确定美国州一级的收入不平等是否与创伤后应激障碍的事件发作有关。NESARC各州的平均基尼系数为0.44 (SD=0.02)，范围为0.39至0.53。在受访者中，有27,638人报告有过创伤性事件。在这个样本中，分别有6.9%和2.3%的人经历了持续性或复发性和偶发性创伤后应激障碍。州一级的不平等与持续或复发性PTSD的几率增加无关（or =1.02; 95% CI=0.85, 1.22），但与偶发性PTSD相关（or =1.30, 95% CI=1.04, 1.63）。在暴露于创伤性事件的个体中，居住州的收入不平等程度与PTSD的易感性有关。需要进一步的工作来确定这种联系是否有因果关系（或者，由与收入不平等相关的其他社会背景因素来解释），如果是这样，什么焦虑机制可以解释它。
Vulnerability to post-traumatic disorder (PTSD) following a traumatic event can be influenced by individual level as well as contextual factors. Characteristics of the social and economic environment might increase the odds for PTSD after traumatic events occur. One example that has been identified as a potential environmental determinant is income inequality. The purpose of this study is to investigate the association between State-level income inequality and PTSD among adults who have been exposed to trauma. We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653). Structured diagnostic interviews were administered at baseline (2001–2002) and follow-up (2004–2005). Weighted multi-level logistic regression was used to determine if US State-level income inequality, as measured by the Gini coefficient, was associated with incident episodes of PTSD during the study’s 3-year follow-up period adjusting for individual and state-level covariates. The mean Gini coefficient across states in the NESARC was 0.44 (SD=0.02) and ranged from 0.39 to 0.53. Of the respondents, 27,638 reported exposure to a traumatic event. Of this sample, 6.9% and 2.3% experienced persistent or recurrent and incident PTSD, respectively. State-level inequality was not associated with increased odds for persistent or recurrent PTSD (OR=1.02; 95% CI=0.85, 1.22), but was associated with incident PTSD (OR=1.30, 95% CI=1.04, 1.63). The degree of income inequality in one’s state of residence is associated with vulnerability to PTSD among individuals exposed to traumatic events. Additional work is needed to determine if this association is causal (or alternatively, is explained by other socio-contextual factors associated with income inequality), and if so, what anxiogenic mechanisms explain it.
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影响因子：
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Acierno, Ron;Ruggiero, Kenneth J;Kilpatrick, Dean G
通讯作者：
Kilpatrick, Dean G
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Kilpatrick, D
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通讯作者：
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