{"title":"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。","authors":"Lumi Bakos","doi":"10.1177/00207640251358330","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"207640251358330"},"PeriodicalIF":2.7000,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Insurance status and psychological distress during the 2007 to 2009 U.S. recession: A novel integrative data analysis approach.\",\"authors\":\"Lumi Bakos\",\"doi\":\"10.1177/00207640251358330\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":14304,\"journal\":{\"name\":\"International Journal of Social Psychiatry\",\"volume\":\" \",\"pages\":\"207640251358330\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Social Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00207640251358330\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Social Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00207640251358330","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
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.
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.