Geographically-based discrimination is a social determinant of mental health in a deprived or stigmatized area in Japan: a cross-sectional study.
Geographically-based discrimination is a social determinant of mental health in a deprived or stigmatized area in Japan: a cross-sectional study.
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DOI：
10.1016/j.socscimed.2012.04.030
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发表时间：
2012-09
影响因子：
5.4
通讯作者：
T. Tabuchi;H. Fukuhara;H. Iso
中科院分区：
文献类型：
--
作者：
T. Tabuchi;H. Fukuhara;H. Iso
事实证明，感知到的歧视与健康有关。然而，不确定基于地理居住地的歧视(基于地理的歧视)，如日本的Buraku或Nishinari歧视是否与健康有关。我们于2009年2月至3月在日本最贫困的地区之一大阪市西奈里区的Buraku区进行了一项横断面研究(响应率=452.3%)。我们实施了性别分层和教育分层的多元回归模型，通过对年龄、社会经济地位、社会关系和生活方式因素的调整，来检验基于地理的歧视与两种心理健康结果(抑郁症状和精神疾病诊断)之间的关系。对居住在该地区的1994名年龄在25-79岁的人(928名男性和1066名女性)进行了分析。在完全调整的模型中，感知到的基于地理的歧视与抑郁症状和精神疾病的诊断显著相关。与女性或受教育程度较低的人相比，男性或受教育程度较高的人更易患此病。基于地域的歧视对心理健康的影响与社会经济地位、社会关系和生活方式因素无关。基于地域的歧视可能是心理健康的社会决定因素之一。
Perceived discrimination has been shown to be associated with health. However, it is uncertain whether discrimination based on geographical place of residence (geographically-based discrimination), such as Buraku or Nishinari discrimination in Japan, is associated with health. We conducted a cross-sectional study (response rate = 52.3%) from February to March 2009 in a Buraku district of Nishinari ward in Osaka city, one of the most deprived areas in Japan. We implemented sex-stratified and education-stratified multivariate regression models to examine the association between geographically-based discrimination and two mental health outcomes (depressive symptoms and diagnosis of mental illness) with adjustment for age, socioeconomic status, social relationships and lifestyle factors. A total of 1994 persons aged 25–79 years (928 men and 1066 women) living in the district were analyzed. In the fully-adjusted model, perceived geographically-based discrimination was significantly associated with depressive symptoms and diagnosis of mental illness. It was more strongly associated among men or highly educated people than among women or among less educated people. The effect of geographically-based discrimination on mental health is independent of socioeconomic status, social relationship and lifestyle factors. Geographically-based discrimination may be one of the social determinants of mental health.