Low education and mental health among older adults: the mediating role of employment and income
Low education and mental health among older adults: the mediating role of employment and income
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DOI：
10.1007/s00127-021-02149-y
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发表时间：
2021-08-06
影响因子：
4.4
通讯作者：
Pirkis, Jane
中科院分区：
文献类型：
--
作者：
Sperandei, Sandro;Page, Andrew;Pirkis, Jane
目的从工作到退休的转变可能与老年群体，特别是那些社会经济地位较低的群体的心理健康状况较差有关。这项研究调查了低教育成就和心理健康状况之间的关系，以及就业状况和收入水平在老年澳大利亚人中的中介作用。方法本研究基于‘45岁及以上研究’，这是一项对澳大利亚新南威尔士州45岁及以上参与者(N=267,153)进行的前瞻性队列研究，在2006-2018年间进行了跟踪调查。采用因果中介分析评估教育程度对心理困扰的总因果效应，以及就业状况和收入水平对心理困扰的中介程度。结果与高教育成就者相比，低教育成就者TCE较高(OR=1.46，95%CI为1.25~1.72)，其次为中等教育成就者(OR=1.26，95%CI为1.07~1.48)。在通过就业状况和收入水平进行中介的模型中，44.7%(95%可信区间为34.2-55.3)的关联是由就业状况和收入水平中介的，其中收入水平的中介作用更强。结论在SEP较低的人群中，老年就业状况和收入水平的变化与较差的心理健康状况有更强的相关性。与较低的SEP相关的较差的心理健康状况可能会得到改善，特别是通过收入水平的变化，以及人们从就业过渡到退休的方式。
Purpose Transition from work to retirement may be associated with poor mental health outcomes in older-age groups, especially among those of lower socio-economic position (SEP). This study investigates the association between low educational achievement and mental health status, and the mediating role of employment status and income level among older-age Australians. Methods This study was based on the '45 and Up Study', a prospective cohort study of participants from New South Wales (Australia) aged 45 years and older (N = 267,153), followed-up over the period 2006-2018. A causal mediation analysis was used to assess the total causal effect (TCE) of educational achievement level on psychological distress, and the extent of mediation by employment status and income level. Results Lower educational achievement was associated with subsequent psychological distress, with a stronger TCE among those with low educational achievement (OR = 1.46, 95% CI 1.25-1.72), followed by those with intermediate educational achievement (OR = 1.26, 95% CI 1.07-1.48), compared to those with high educational achievement. In models investigating mediation by employment status and income level, 44.7%, (95% CI 34.2-55.3) of the association was mediated by employment status and income level, with a stronger mediating effect evident for income level. Conclusion Findings suggest that employment status and income level changes at older age are more strongly associated with poorer mental health among those of lower SEP. Poor mental health associated with lower SEP may be ameliorated particularly by changes to income level, but also how people transition from employment to retirement.