土著居民和托雷斯海峡岛民中抑郁症和焦虑症的人口可归因比例:一项基于人口的研究

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Subash Thapa , Kedir Y. Ahmed , Santosh Giri , Anayochukwu E. Anyasodor , M. Mamun Huda , Peter Gibbs , Shakeel Mahmood , Feleke H. Astawesegn , Jamie Newman , Allen G. Ross
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引用次数: 0

摘要

背景土著居民和托雷斯海峡岛民罹患常见精神障碍的风险增加,这可能与潜在的社会经济挑战、种族主义和歧视有关。这是第一项计算年龄≥15岁的原住民和托雷斯海峡岛民因健康行为、社会和文化特征以及既往不良事件等潜在可改变风险因素导致的抑郁症和焦虑症人群可归因分数(PAFs)的研究。方法这项横断面研究考察了澳大利亚统计局开展的2018-19年全国原住民和托雷斯海峡岛民健康调查。采用逻辑回归模型计算几率比(ORs)。使用调整后的 ORs 和每个风险因素的患病率估计值计算出根据社区性调整后的 PAFs。个人收入低于全国平均水平(PAF = 13.4%; 95% CI: 12.4, 14.5)、与土著文化的联系被切断(PAF = 12.8%; 95% CI: 11.8, 13.8)、中心性肥胖(PAF = 7.2%; 95% CI: 6.4, 8.0)、每天吸烟(PAF = 5.9%; 95% CI: 5.2, 6.7)和与土著知识断绝联系(PAF = 5.2%; 95% CI: 4.5, 5.8)与 45% 的抑郁症病例有关。个人收入低于全国平均水平(PAF = 10.7%; 95% CI: 9.8, 11.7)、获得原住民社区控制医疗服务的机会有限(PAF = 10.6%; 95% CI: 9.7, 11.6)、中心性肥胖(PAF = 7.1%; 95% CI: 6.3,7.9)、无法获得土著知识(PAF = 5.7%;95% CI:4.9,6.4)和在过去 12 个月中遭受歧视(PAF = 4.7%;95% CI:4.0,5.3)与 39% 的焦虑病例有关。为减轻原住民和托雷斯海峡岛民的抑郁症和焦虑症负担,应优先解决制约与人/亲属、其权利、语言、土地和健康食物来源之间健康联系的社会经济和文化危害。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Population attributable fractions of depression and anxiety among Aboriginal and Torres Strait Islander peoples: a population-based study

Background

Aboriginal and Torres Strait Islander peoples face an increased risk of common mental disorders, which may be associated with underlying socio-economic challenges, racism, and discrimination. This is the first study to calculate the population attributable fractions (PAFs) for depression and anxiety attributed to potentially modifiable risk factors such as health behaviour, social and cultural characteristics, and past adverse events among Aboriginal and Torres Strait Islander peoples aged ≥15 years.

Methods

This cross-sectional study examined the 2018–19 National Aboriginal and Torres Strait Islander Health Survey conducted by the Australian Bureau of Statistics. Logistic regression models were used to compute odds ratios (ORs). PAFs adjusted for communality were calculated using adjusted ORs and prevalence estimates for each risk factor.

Findings

This study included a weighted sample of 5362 individuals, with a mean age of 40.8 years (SD = ±17.2). Personal income below the national average (PAF = 13.4%; 95% CI: 12.4, 14.5), severed access to Indigenous cultural affiliations (PAF = 12.8%; 95% CI: 11.8, 13.8), central obesity (PAF = 7.2%; 95% CI: 6.4, 8.0), daily smoking (PAF = 5.9%; 95% CI: 5.2, 6.7) and severed access to Indigenous knowledge (PAF = 5.2%; 95% CI: 4.5, 5.8) were associated with 45% of depression cases. Personal income below the national average (PAF = 10.7%; 95% CI: 9.8, 11.7), limited access to Aboriginal Community Controlled Health Services (PAF = 10.6%; 95% CI: 9.7, 11.6), central obesity (PAF = 7.1%; 95% CI: 6.3, 7.9), severed access to Indigenous knowledge (PAF = 5.7%; 95% CI: 4.9, 6.4) and the experience of discrimination in the last 12 months (PAF = 4.7%; 95% CI: 4.0, 5.3) were associated with 39% of anxiety cases.

Interpretation

To reduce the burden of depression and anxiety disorder among Aboriginal and Torres Strait Islander peoples, addressing socio-economic and cultural harms that constrain healthy connections to people/kin, their rights, languages, land, and healthy food sources should be a priority.

Funding

This work was funded by a grant from the Commonwealth of Australia, represented by the Department of Health and Aged Care (Grant Activity 4-DGEJZ1O/4-CW7UT14).

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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