Cause and context: place-based approaches to investigate how environments affect mental health.

Cause and context: place-based approaches to investigate how environments affect mental health.
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DOI:
10.1007/s00127-016-1300-x
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发表时间:
2016-12
影响因子:
4.4
通讯作者:
DiMaggio C
DiMaggio C
中科院分区:
医学2区
文献类型:
--
作者:
Lovasi GS;Mooney SJ;Muennig P;DiMaggio C

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我们的周围环境会影响我们的情绪、我们的压力恢复、我们的行为,并最终影响我们的心理健康。了解周围环境如何影响心理健康对于创建健康城市至关重要。然而,目前在精神病学流行病学文献中占主导地位的传统观察分析不足以获得这样的理解。其他策略,例如随机放置人员、随机更改位置或利用模仿随机实验的自然实验,每种策略都有其优点和缺点。我们讨论这些优点和缺点的方面包括:(1)定义最相关的背景规模和特征,(2)将背景的影响与个人偏好和先前健康状况的影响分开,以及(3)概括研究环境之外的因果效应。有前途的替代策略包括创建许多小规模随机基于地点的试验,使用随着时间的推移部署基于地点的变化作为自然实验,以及利用周围环境变化的波动与新兴的数据收集技术相结合,以更好地了解周围环境如何影响情绪、行为和心理健康。改善现有的研究策略需要心理健康领域的专家、提出研究场所对健康影响的新方法的专家以及寻求优化当地环境设计的专家之间的跨学科合作。
Our surroundings affect our mood, our recovery from stress, our behavior, and, ultimately, our mental health. Understanding how our surroundings influence mental health is central to creating healthy cities. However, the traditional observational analyses now dominant in the psychiatric epidemiology literature are not sufficient to garner such an understanding. Alternative strategies, such as randomizing people to place, randomizing places to change, or harnessing natural experiments that mimic randomized experiments each have their strengths and weaknesses. We discuss these strengths and weaknesses with respect to (1) defining the most relevant scale and characteristics of context, (2) disentangling the effects of context from the effects of individuals’ preferences and prior health, and (3) generalizing causal effects beyond the study setting. Promising alternative strategies include creating many small-scale randomized place-based trials, using the deployment of place-based changes over time as natural experiments, and using fluctuations in the changes in our surroundings in combination with emerging data collection technologies to better understand how surroundings influence mood, behavior, and mental health. Improving existing research strategies will require interdisciplinary partnerships between those specialized in mental health, those advancing new methods for place effects on health, and those who seek to optimize the design of local environments.
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