Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community Health (SELCoH) study
Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community Health (SELCoH) study
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DOI：
10.1186/1471-2458-11-861
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发表时间：
2011-11-11
影响因子：
4.5
通讯作者：
Hotopf, Matthew
中科院分区：
文献类型：
--
作者：
Hatch, Stephani L.;Frissa, Souci;Hotopf, Matthew
背景：对公共卫生需求的响应需要关于当地社区层面按人口和社会经济因素划分的精神和身体疾病分布的信息。方法：伦敦东南部社区健康(SELCoH)研究是一项社区精神和身体疾病发病率调查。训练有素的面试者对1698名年龄在16岁及以上的成年人进行了面对面的计算机辅助采访，他们来自伦敦南部两个行政区随机挑选的1076户私人家庭。我们通过人口学和社会经济学指标比较了常见精神障碍、危险饮酒、长期疾病和总体身体健康的患病率。结果：在样本中，24.2%的人报告了常见的精神障碍，44.9%的人报告了长期患病，15.7%的人报告了危险饮酒，19.2%的人认为自己的健康状况一般或很差。确定常见精神障碍、一般健康状况差和长期患病的健康不平等的指标模式相似；处于社会经济不利地位的个人健康状况较差，身体健康状况随着所有群体年龄的增长而恶化。按族裔分列的不良健康结果的发生率表明，不同群体之间存在重要差异，特别是在常见的精神障碍和一般健康状况较差方面。较高的社会经济地位对常见的精神障碍、一般或较差的健康状况和长期疾病具有保护作用，但那些社会经济地位较高的人报告的危险酒精使用水平更高。符合常见精神障碍伴发功能障碍标准的参与者比例与身体健康较差者相似或更高。结论：卫生服务提供者和政策制定者应优先考虑高危、社会界定的群体，以应对个体和共生的不良心理和身体问题的不平等。就人群而言，心理健康不良对功能损害的负担与长期疾病和感知健康相似或更大。
Background: Responses to public health need require information on the distribution of mental and physical ill health by demographic and socioeconomic factors at the local community level.Methods: The South East London Community Health (SELCoH) study is a community psychiatric and physical morbidity survey. Trained interviewers conducted face-to-face computer assisted interviews with 1698 adults aged 16 years and over, from 1076 randomly selected private households in two south London boroughs. We compared the prevalence of common mental disorders, hazardous alcohol use, long standing illness and general physical health by demographic and socioeconomic indicators. Unadjusted and models adjusted for demographic and socioeconomic indicators are presented for all logistic regression models.Results: Of those in the sample, 24.2% reported common mental disorder and 44.9% reported having a long standing illness, with 15.7% reporting hazardous alcohol consumption and 19.2% rating their health as fair or poor. The pattern of indicators identifying health inequalities for common mental disorder, poor general health and having a long term illness is similar; individuals who are socioeconomically disadvantaged have poorer health and physical health worsens as age increases for all groups. The prevalence of poor health outcomes by ethnic group suggests that there are important differences between groups, particularly for common mental disorder and poor general health. Higher socioeconomic status was protective for common mental disorder, fair or poor health and long standing illness, but those with higher socioeconomic status reported higher levels of hazardous alcohol use. The proportion of participants who met the criteria for common mental disorder with co-occurring functional limitations was similar or greater to those with poor physical health.Conclusions: Health service providers and policy makers should prioritise high risk, socially defined groups in combating inequalities in individual and co-occurring poor mental and physical problems. In population terms, poor mental health has a similar or greater burden on functional impairment than long term conditions and perceived health.