The association of major depressive episodes with income inequality and the human development index
The association of major depressive episodes with income inequality and the human development index
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DOI：
10.1016/j.socscimed.2008.04.003
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发表时间：
2008-08-01
影响因子：
5.4
通讯作者：
Punnett, Laura
中科院分区：
文献类型：
--
作者：
Cifuentes, Manuel;Sembaljwe, Grace;Punnett, Laura
本研究的目的是评估国家收入分配和人类发展与各国 12 个月重度抑郁发作之间的关系。世界卫生组织从2002年到2003年对来自65个国家的总共251,158人进行了调查。该调查包含用于识别过去 12 个月内重度抑郁发作 (MDE) 的项目、受教育程度（用作个人社会经济地位的指标）和其他人口统计信息。收入不平等是用国家级指标基尼指数来衡量的；联合国人类发展指数（HDI）衡量国家整体发展水平。利用国家级和多级线性回归模型来研究这种关联。我们发现，中等发达国家的 MDE 调整患病率最低，其次是高发达国家和低发达国家。基尼指数与重度抑郁症发作呈正相关，但仅限于高人类发展指数国家。调整年龄、性别、婚姻状况、教育程度和 HDI 后，多级患病率表明，生活在收入平等增加 1% 的国家的人，患 MDE 的风险增加 4%。例如，这一发现意味着，比较两个高度发达国家，一个收入不平等程度较低（基尼系数 = 0.25）和另一个收入不平等程度较高（基尼系数 = 0.39），人们预计 MDE 的患病率会从 4.0% 增加到 6.2%。这些发现提出了关于收入不平等对可能导致抑郁症的社会力量的作用的重要问题。 (C) 2008 Elsevier Ltd，保留所有权利。
The aim of this study was to estimate the association between country income distribution and human development with the 12-month occurrence of major depressive episodes across countries. A total of 251,158 people surveyed by the World Health Organization from 2002 to 2003 from 65 Countries were included in the study. The survey contained items for identifying major depressive episodes (MDE) in the previous 12 months, attained education (used as an indicator of individual socioeconomic status) and other demographic information. Income inequality was measured with the Gini index, a national-level indicator; the United Nations human development index (HDI) measured overall Country development. Country-level and multilevel linear regression models were utilized to Study the associations.We found that moderately developed countries had the lowest adjusted prevalence of MDE followed by high and low developed countries. The Gini index was positively associated with major depressive episodes, but only among high HDI countries. After adjusting for age, gender, marital status, education and HDI, the multilevel prevalence ratio indicated a 4% increase in risk of MDE fora person living in a country associated with a 1% increment in income equality. This finding means, for example, that comparing two highly developed countries, one with low income inequality (Gini = 0.25) with another with high income inequality (Gini = 0.39), one would expect to see an increase in the prevalence of MDE from 4.0% to 6.2%. These findings raise important questions about the role of income inequality on social forces that can lead to depression. (C) 2008 Elsevier Ltd, All rights reserved.