Associations of relative deprivation and income rank with depressive symptoms among older adults in Japan.
Associations of relative deprivation and income rank with depressive symptoms among older adults in Japan.
复制标题
DOI：
10.1016/j.socscimed.2017.07.028
复制
发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Kawachi I
中科院分区：
文献类型：
--
作者：
Gero K;Kondo K;Kondo N;Shirai K;Kawachi I
假设收入不仅通过物质途径(即购买增进健康的商品的能力)影响健康，而且还通过心理社会途径(例如与他人的社会比较)影响健康。与收入的心理社会影响有关的两个概念是：相对剥夺(例如，用衡量个人收入差异的伊扎基指数表示)和收入排名。这项研究调查了较高的相对贫困和较低的收入等级是否与独立于绝对收入的老年人口的抑郁症状有关。利用日本老年学评估研究(JAGES)中83,100名参与者(40,038名男性和43,062名女性)的横断面数据，应用多元Logistic回归模型计算与相对剥夺/收入排名相关的抑郁症的优势比(OR)。采用日本老年抑郁量表(GDS-15)评定抑郁症状，≥评分为5分为抑郁。根据相同的性别、年龄段和居住地，构建了计算伊扎基指数和收入排名的参考组。研究结果表明，在控制了人口统计学因素后，男性的相对剥夺每增加10万日元，相对排名降低0.1个单位，患抑郁症的几率分别增加1.07倍(95%CI：1.07，1.08)和1.15倍(95%CI：1.14，1.16)。女性的OR值分别为1.05(95%CI：1.05，1.06)和1.12(95%CI：1.11，1.13)。在调整其他协变量并按收入四分位数分层后，结果仍然具有统计学意义。处于最高收入四分位数的女性似乎更容易受到低收入排名对心理健康不利影响的影响，而在男性中，这种关联相反，低收入排名对穷人的影响似乎更大。相对收入的概念似乎除了绝对收入的影响外，还与心理健康有关。
Income is hypothesized to affect health not just through material pathways (i.e. the ability to purchase health-enhancing goods) but also through psychosocial pathways (e.g. social comparisons with others). Two concepts relevant to the psychosocial effects of income are: relative deprivation (for example expressed by the Yitzhaki Index, measuring the magnitude of difference in income among individuals) and Income Rank. This study examined whether higher relative deprivation and lower Income Rank are associated with depressive symptoms in an older population independently of absolute income. Using cross-sectional data of 83,100 participants (40,038 men and 43,062 women) in the Japan Gerontological Evaluation Study (JAGES), this study applied multiple logistic regression models to calculate the odds ratios (OR) of depression associated with relative deprivation/Income Rank. The Japanese Geriatric Depression Scale (GDS-15) was used to assess depressive symptoms, and subjects with a score of ≥5 were categorized as depressed. Reference groups for calculating Yitzhaki Index and Income Rank were constructed based on same gender, age-group, and municipality of residence. The findings indicated that after controlling for demographic factors, each 100,000 yen increase in relative deprivation and 0.1 unit decrease in relative rank was associated with a 1.07 (95% CI: 1.07, 1.08) and a 1.15 (95% CI: 1.14, 1.16) times higher odds of depression, respectively, in men. The corresponding ORs in women were 1.05 (95% CI: 1.05, 1.06) and 1.12 (95% CI: 1.11, 1.13), respectively. After adjustment for other covariates and stratification by income quartiles, the results remained statistically significant. Women in the highest income quartile appeared to be more susceptible to the adverse mental health effects of low Income Rank, while among men the associations were reversed, low Income Rank appeared more toxic for the poor. Concepts of relative income appear to be relevant for mental health over and above the effects of absolute income.
登录
查看更多内容
影响因子：
5.4
作者：
Kondo, Naoki;Kawachi, Ichiro;Subramanian, S. V.;Takeda, Yasuhisa;Yamagata, Zentaro
通讯作者：
Yamagata, Zentaro
影响因子：
--
作者：
Lyness, JM;Noel, TK;Caine, ED
通讯作者：
Caine, ED
影响因子：
105.7
作者：
Marmot, M;Wilkinson, RG
通讯作者：
Wilkinson, RG
影响因子：
4.8
作者：
PARKER, RN;FENWICK, R
通讯作者：
FENWICK, R
影响因子：
8.2
作者：
Boyce, Christopher J.;Brown, Gordon D. A.;Moore, Simon C.
通讯作者：
Moore, Simon C.