2007 - 2009年美国经济衰退期间的保险状况和心理困扰:一种新颖的综合数据分析方法。

IF 2.7 4区 医学 Q2 PSYCHIATRY
Lumi Bakos
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引用次数: 0

摘要

背景:2007年至2009年的美国经济衰退与广泛的失业、住房不稳定和不断上升的心理健康挑战有关。虽然以前的研究将经济衰退与心理困扰联系起来,但有限的研究已经调查了健康保险状况如何在经济衰退期间和之后改变这种关系。目的:本研究调查了2007 - 2009年经济衰退之前、期间和之后美国成年人心理困扰(PD)的变化,并考察了保险状况是否介导了经济困难与PD之间的关系。方法:利用行为风险因素监测系统(BRFSS) 2007年、2009年、2012年和2013年的数据,采用综合数据分析(IDA)框架构建复合人口统计特征并近似纵向趋势。采用结构方程模型(SEM),包括探索性和验证性因子分析、面板模型和中介分析,研究了PD趋势以及保险覆盖率和收入的影响。结果:探索性和验证性因素分析证实了PD的双因素结构:抑郁和焦虑症状。从2007年到2009年,PD保持稳定,但在2009年至2012年期间,PD水平有所提高。较高的未参保率显著增加了PD,未参保人口增加1%导致PD上升17.4%。中介分析表明,获得精神健康治疗的机会有限,部分解释了没有保险和痛苦增加之间的关系。结论:健康保险状况对经济衰退时期心理困扰的调节起关键作用。扩大保险覆盖面和将心理健康服务纳入经济复苏工作,可减轻金融危机对心理健康的长期影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Insurance status and psychological distress during the 2007 to 2009 U.S. recession: A novel integrative data analysis approach.

Background: The 2007 to 2009 U.S. economic recession was associated with widespread job loss, housing instability, and rising mental health challenges. While previous studies have linked economic downturns to psychological distress, limited research has examined how health insurance status modifies this relationship during and after a recession.

Aims: This study investigated changes in psychological distress (PD) among U.S. adults before, during, and after the 2007 to 2009 recession and examined whether insurance status mediated the relationship between economic hardship and PD.

Methods: Using Behavioral Risk Factor Surveillance System (BRFSS) data from 2007, 2009, 2012, and 2013, the study applied an integrative data analysis (IDA) framework to construct composite demographic profiles and approximate longitudinal trends. Structural equation modeling (SEM), including exploratory and confirmatory factor analysis, panel modeling, and mediation analysis, was used to examine PD trends and the influence of insurance coverage and income.

Results: Exploratory and confirmatory factor analyses confirmed a two-factor structure of PD: depression and anxiety symptoms. From 2007 to 2009, PD remained stable, but levels improved between 2009 and 2012. Higher uninsured rates significantly increased PD, with a 1% increase in the uninsured population resulting in a 17.4% rise in PD. Mediation analysis showed that limited access to mental health treatment partially explained the relationship between being uninsured and increased distress.

Conclusion: Health insurance status plays a critical role in moderating psychological distress during economic downturns. Expanding insurance coverage and integrating mental health services into economic recovery efforts may mitigate long-term mental health consequences of financial crises.

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来源期刊
CiteScore
12.30
自引率
1.30%
发文量
120
期刊介绍: The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities. Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas. The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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