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

项目摘要/摘要 在撒哈拉以南非洲(SSA)进行的几项研究结果表明，该地区的成年人有 在许多中等和高收入国家，抑郁症的患病率高于其他国家。这个 全球疾病负担研究估计，精神和物质使用障碍占19% 撒哈拉以南非洲的残疾年和南非压力与健康研究--2003-2004年进行 作为世界卫生组织世界精神健康调查倡议的一部分-发现一生和12岁- 月精神障碍患病率分别为30.3%和16.5%。尽管流行率很高， 然而，人们对心理健康结果的决定因素以及动态变化知之甚少。 区域。以前对SSA的研究在很大程度上依赖于一些横断面数据集，并集中在 心理健康与一组有限的人口统计特征之间的联系。而在SSA之外的学习 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)影响心理健康结果，关于SSA中这种影响的研究很少，甚至没有 尽管与疾病和事故相关的死亡和精神障碍在该区域具有双重重要性。这个 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 南非人口调查，国民收入动态研究(NIDS)。NID的数据跨度为7- 年期间(2008-2015年)，载有关于家庭内死亡率和其他次要死亡事件的详细资料，以及 包括衡量所有成年家庭成员的抑郁症状。该项目的目标1是探索 并评估南非7年来的心理健康趋势，包括向贫困或脱离贫困的转变 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。目标 该项目的第二部分是确定家庭成员死亡前后抑郁的模式 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 技术包括具有个人固定效果和时间趋势的模型。该项目最终将增强 我们对死亡率如何影响南非精神健康结果的理解，并帮助确定 对精神健康服务的需求程度，以及如何改进有针对性地提供这类服务。

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.