Measuring the neighbourhood using UK benefits data: a multilevel analysis of mental health status.
Measuring the neighbourhood using UK benefits data: a multilevel analysis of mental health status.
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DOI：
10.1186/1471-2458-7-69
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发表时间：
2007-05-03
影响因子：
4.5
通讯作者：
Dunstan FD
中科院分区：
文献类型：
--
作者：
Fone DL;Lloyd K;Dunstan FD
来自多层次研究的证据调查了人们居住的地方是否影响他们的心理健康仍然没有定论。本研究的目的是使用工作和养老金部（DWP）的福利数据得出当地社会环境的小区域水平或背景测量，并调查（1）在调整心理健康不良的个人风险因素后，个人的心理健康状况是否与低收入，经济不活跃和残疾的背景测量相关，（2）心理健康与环境之间的关系在不同的人口亚组之间存在显著差异;（3）比较环境福利措施与汤森地区剥夺评分的效果。从威尔士健康调查1998年的数据进行了分析，在正常反应的多层次模型的24 975个人，年龄在17至74岁，生活在833个病房和22个单一的权力机构在威尔士。心理健康结果的测量是心理健康量表（MHI-5）的简表36健康状况问卷。现有的福利数据包括经经济状况调查的收入支助和基于收入的求职者津贴，以及未经经济状况调查的丧失工作能力津贴、严重残疾津贴、残疾生活津贴和护理津贴。间接年龄标准化的人口普查病房比例计算模型的上下文措施。在调整了个人风险因素后，每个背景变量与个人心理健康显著相关，因此，生活在索赔人水平高的病房与心理健康状况较差有关。作为永久性疾病或残疾导致的经济不活跃的替代措施的非经济状况调查福利与个人心理健康的关联性强于经济状况调查福利和汤森评分。所有的背景效应在那些不从事经济活动和无法工作的人身上都显着更强。这项研究提供了证据，对心理健康的实质性的背景影响，特别是经济活动和残疾的小面积水平的重要性。DWP福利数据提供了一个更具体的措施，当地的邻里比通用的剥夺指数，并提供了一个起点，假设可能的因果途径，以个人的心理健康状况。
Evidence from multilevel research investigating whether the places where people live influence their mental health remains inconclusive. The objectives of this study are to derive small area-level, or contextual, measures of the local social environment using benefits data from the Department of Work and Pensions (DWP) and to investigate whether (1) the mental health status of individuals is associated with contextual measures of low income, economic inactivity, and disability, after adjusting for personal risk factors for poor mental health, (2) the associations between mental health and context vary significantly between different population sub-groups, and (3) to compare the effect of the contextual benefits measures with the Townsend area deprivation score. Data from the Welsh Health Survey 1998 were analysed in Normal response multilevel models of 24,975 individuals aged 17 to 74 years living within 833 wards and 22 unitary authorities in Wales. The mental health outcome measure was the Mental Health Inventory (MHI-5) of the Short Form 36 health status questionnaire. The benefits data available were the means tested Income Support and Income-based Job Seekers Allowance, and the non-means tested Incapacity Benefit, Severe Disablement Allowance, Disability Living Allowance and Attendance Allowance. Indirectly age-standardised census ward ratios were calculated to model as the contextual measures. Each contextual variable was significantly associated with individual mental health after adjusting for individual risk factors, so that living in a ward with high levels of claimants was associated with worse mental health. The non-means tested benefits that were proxy measures of economic inactivity from permanent sickness or disability showed stronger associations with individual mental health than the means tested benefits and the Townsend score. All contextual effects were significantly stronger in people who were economically inactive and unavailable for work. This study provides evidence for substantive contextual effects on mental health, and in particular the importance of small-area levels of economic inactivity and disability. DWP benefits data offer a more specific measure of local neighbourhood than generic deprivation indices and offer a starting point to hypothesise possible causal pathways to individual mental health status.
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影响因子：
4.6
作者：
Beatty, C;Fothergill, S
通讯作者：
Fothergill, S
影响因子：
5.4
作者：
Fone, David;Dunstan, Frank;Palmer, Stephen
通讯作者：
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影响因子：
6.3
作者：
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通讯作者：
BOOTH, M
影响因子：
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作者：
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通讯作者：
Galster, G
影响因子：
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通讯作者：
Cummins, S