Financial loss in pyramid savings schemes, downward social mobility and acute coronary syndrome in transitional Albania
Financial loss in pyramid savings schemes, downward social mobility and acute coronary syndrome in transitional Albania
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DOI：
10.1136/jech.2007.066001
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发表时间：
2008-07-01
影响因子：
6.3
通讯作者：
Kark, J. D.
中科院分区：
文献类型：
--
作者：
Burazeri, G.;Goda, A.;Kark, J. D.
目标：传销储蓄计划的崩溃造成了巨大的经济损失，导致了1997年阿尔巴尼亚的动荡。作者的目的是评估经济损失和社会流动性与急性冠状动脉综合征(ACS)的相关性。方法：2003-6年间，在阿尔巴尼亚首都地拉那进行了一项以人群为基础的病例对照研究。467例非致死性急性冠脉综合征患者(男性370例，年龄59.1(SD8.7)岁；女性97例，年龄63.3(SD7.1)岁，有效率88%)。对照组包括469名男性(53.1(SD 10.4)岁)和268名女性(54.0(SD 10.9)岁，有效率69%)。关于绝对经济损失(美元)、相对损失和主观社会流动性的信息是通过访谈者管理的结构化问卷获得的。结果：传销诈骗中的经济损失在急性冠脉综合征患者(55%)和对照组(41%)中均较常见。31%的患者和12%的对照组观察到主观社会流动性下降。在调整了社会人口学和社会经济学特征以及传统的冠状动脉危险因素后，ACS与经济损失(OR 1.9，95%CI 1.4~2.6)和社会流动性下降(OR 2.2，95%CI 1.4~3.3)有关。虽然与经济损失的关系部分通过主观社会流动性来调节，但两者都与ACS保持着独立的联系。结论：在一场全国性的灾难性储蓄崩溃导致阿尔巴尼亚国内生产总值约40%的损失之后，作者发现了经济损失和代内主观社会流动性下降的明显的长期有害健康影响。
Objective: Extensive financial losses caused by the collapse of pyramid savings schemes led to the 1997 turmoil in Albania. The authors' aim was to assess the association of financial loss and social mobility with acute coronary syndrome (ACS) 6-9 years after the precipitous collapse.Methods: A population-based case-control study was conducted in Tirana, the Albanian capital, in 2003-6. 467 non-fatal consecutive ACS patients were recruited ( 370 men aged 59.1 (SD8.7) years and 97 women 63.3 (SD 7.1) years, 88% response). The control group comprised 469 men (53.1 ( SD 10.4) years) and 268 women (54.0 ( SD 10.9) years, 69% response). Information on the absolute financial loss ( in US$), relative loss and subjective social mobility was obtained by a structured interviewer-administered questionnaire. Associations of financial loss and social mobility with ACS were assessed by multivariable-adjusted logistic regression.Results: Financial loss in pyramid scams was frequent in both ACS patients (55%) and controls (41%). Downward subjective social mobility was noted in 31% of patients and 12% of controls. Upon adjustment for sociodemo-graphic and socioeconomic characteristics and conventional coronary risk factors, ACS was associated with both financial loss ( OR 1.9, 95% CI 1.4 to 2.6) and downward social mobility ( OR 2.2, 95% CI 1.4 to 3.3). Although the association with financial loss was partly mediated through subjective social mobility, both maintained independent associations with ACS.Conclusions: In the wake of a nationwide catastrophic collapse of savings that led to losses totalling about 40% of the Albanian gross domestic product, the authors detected apparent long-term deleterious health effects of financial loss and downward intragenerational subjective social mobility.