Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies.
Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies.
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DOI：
10.1017/s0033291717003580
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发表时间：
2018-09
影响因子：
6.9
通讯作者：
Das-Munshi J
中科院分区：
文献类型：
--
作者：
Bécares L;Dewey ME;Das-Munshi J
尽管在经济较发达的国家，少数民族的居住密度（种族密度）对心理健康是有害的还是有益的，但目前还不清楚。这是第一个涵盖国际文献的系统回顾和荟萃分析，评估种族密度与心理健康结果的关系。我们系统检索了Medline、PsychInfo、Sociological Abstracts、Web of Science，检索时间为2016年3月31日。我们从研究作者那里获得了额外的数据。我们进行了随机效应荟萃分析，考虑了数据集中估计的聚类。meta回归评估了由于种族、国家、世代和地区水平的剥夺而导致的研究异质性。我们的主要研究对象是民族密度，定义为本种族/少数民族的居住集中。结果包括抑郁、焦虑和常见精神障碍（CMD）、自杀、自杀倾向、精神病经历和精神病。我们纳入了41项研究，并对12项研究进行了荟萃分析。在荟萃分析中，我们发现，本民族密度每增加10个百分点，精神病经历(OR:0.82（95% CI:0.76-0.89）和自杀意念(OR:0.88（95% CI:0.79-0.98）的相对几率就会大幅降低。对于CMD、抑郁和焦虑，相关性表明自身种族密度的保护作用，但结果没有统计学意义。叙述性回顾的结果与meta分析的结果一致。研究结果支持各国和种族/少数民族人口以及心理健康结果之间一致的保护性种族密度关联。这可能表明社会环境在影响边缘化和被排斥人口群体的有害心理健康结果方面的重要性。
Despite increased ethnic diversity in more economically developed countries it’s unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes. We systematically searched Medline, PsychInfo, Sociological Abstracts, Web of Science from inception to March 31st, 2016. We obtained additional data from study authors. We conducted random effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences and psychosis. We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences (OR:0.82(95% CI:0.76-0.89) and suicidal ideation (OR:0.88(95% CI:0.79-0.98) for each 10 percentage-point increase in own ethnic density. For CMD, depression and anxiety, associations were indicative of protective effects of own ethnic density however results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis. The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.