Assessing the effect of household member mortality on mental health outcomes using longitudinal data from South Africa

使用南非的纵向数据评估家庭成员死亡率对心理健康结果的影响

• 批准号: 9181170
• 负责人: HARSHA THIRUMURTHY
• 金额: $ 7.33万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-25 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9181170
• 关键词: AIDS/HIV problem; Accidents; Accounting; Acquired Immunodeficiency Syndrome; Adopted; Adult; Affect; Africa South of the Sahara; Age; Attention; Cessation of life; Characteristics; Communities; Country; Data; Data Set; Disease; Eastern Africa; Economics; Employment; Epidemic; Epidemiologic Studies; Event; Face; Family member; General Population; Government; Health; Health Surveys; Health system; Heterogeneity; High Prevalence; Household; Income; Individual; Life; Life Cycle Stages; Longitudinal Surveys; Low income; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Modeling; Natural Disasters; Outcome; Pathway interactions; Pattern; Persons; Policies; Population; Poverty; Prevalence; Psyche structure; Reporting; Research; Respondent; Risk; Role; Services; Shapes; Social Protection; South Africa; South African; Southern Africa; Stress; Subgroup; Substance Use Disorder; Techniques; Testing; Time; Traffic accidents; Twin Multiple Birth; Violence; Work; World Health Organization; abstracting; base; burden of illness; depressive symptoms; disability; evidence base; experience; improved; interest; low and middle-income countries; low income country; member; mortality; novel; population based; population health; poverty alleviation; programs; public health relevance; scale up; stem; trend

Project Summary/Abstract Findings from several studies conducted in sub-Saharan Africa (SSA) suggest that adults in the region have higher prevalence of depression than their counterparts in many middle- and high-income countries. The Global Burden of Disease Study estimated that mental and substance use disorders account for 19% of disability years in sub-Saharan Africa and the South African Stress and Health study – conducted in 2003-2004 as part of the World Health Organization's World Mental Health Survey Initiative – found a lifetime and 12- month prevalence of mental disorders of 30.3% and 16.5%, respectively. Despite the high prevalence, however, little is known about the determinants as well as the dynamics of mental health outcomes in the region. Prior research in SSA has largely relied on a few cross-sectional datasets and focused on the association between mental health and a limited set of demographic characteristics. While studies outside SSA have utilized longitudinal data to examine how economic crises, natural disasters, and other stressful life events (SLEs) influence mental health outcomes, there has been little to no research on such effects in SSA despite the twin significance of disease- and accident-related mortality and mental disorders in the region. The proposed project will fill this important gap by utilizing data from the first nationally representative longitudinal survey of the South African population, the National Income Dynamics Study (NIDS). The NIDS data span a 7- year period (2008-2015), contain detailed information on mortality and other SLEs within households, and include measures of depressive symptoms for all adult household members. Aim 1 of the project is to explore and assess trends in mental health in South Africa over a 7-year period, including transitions into or out of poor mental health and the role of individual, household, and community factors in explaining these transitions. Aim 2 of the project is to determine patterns in depression before and after the mortality of a household member as well as other positive and negative events occurring in the household. Analyses will use panel data regression techniques including models with individual fixed effects and time trends. The project will ultimately enhance our understanding of how mortality is influencing mental health outcomes in South Africa and help determine the level of need for mental health services as well as ways to improve the targeted provision of such services.

项目总结/摘要 在撒哈拉以南非洲进行的几项研究结果表明，该地区的成年人 抑郁症的患病率高于许多中等收入和高收入国家的同龄人。的 全球疾病负担研究估计，精神和物质使用障碍占19%， 2003-2004年进行的撒哈拉以南非洲残疾人年和南非压力与健康研究 作为世界卫生组织世界精神卫生调查倡议的一部分， 月精神障碍患病率分别为30.3%和16.5%。尽管发病率很高， 然而，人们对决定因素以及心理健康结果的动态知之甚少， 地区SSA的先前研究在很大程度上依赖于一些横截面数据集，并专注于 心理健康与一组有限的人口统计学特征之间的关联。在SSA之外的研究 利用纵向数据来研究经济危机、自然灾害和其他紧张的生活 事件（SLEs）影响心理健康的结果，有很少或没有研究在SSA的这种影响 尽管该区域与疾病和事故有关的死亡率和精神障碍具有双重意义。的 拟议的项目将通过利用第一个具有全国代表性的纵向数据来填补这一重要空白。 南非国民收入动态研究（National Income Dynamics Study，NIDS）NIDS数据跨越7- 年期间（2008-2015年），包含关于家庭内死亡率和其他SLE的详细信息，以及 包括对所有成年家庭成员抑郁症状的测量。该项目的目标1是探索 并评估南非7年期间的心理健康趋势，包括进入或脱离贫困的过渡 心理健康以及个人、家庭和社区因素在解释这些转变中的作用。目的 该项目的第二部分是确定家庭成员死亡前后抑郁症的模式， 以及家庭中发生的其他积极和消极事件。分析将使用面板数据回归 技术，包括具有个体固定效应和时间趋势的模型。该项目最终将提高 我们对死亡率如何影响南非心理健康结果的理解， 对精神卫生服务的需求程度以及改进有针对性地提供此类服务的方法。