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影响成都市乡城流动人口心理健康变化的社会决定因素:基于Oaxaca-Blinder分解法

Social Determinants Affecting Changes in Mental Health of Rural-Urban Migrant Population in Chengdu: An Oaxaca-Blinder Decomposition Analysis

  • 摘要:
      目的   探讨影响成都市乡城流动人口心理健康变化的社会决定因素。
      方法   利用2009年及2018年两次成都市流动人口横截面调查数据,通过多重线性回归分析影响成都市乡城流动人口心理健康的社会决定因素,并用Oaxaca-Blinder分解法分析十年间健康社会决定因素变化对心理健康差异的贡献。
      结果   本研究纳入成都市乡城流动人口3091例,调查年份为2009年的有965人(31.22%),2018年的有2126人(68.78%)。将心理健康总评分(mental component summary ,MCS)作为因变量,健康社会决定因素为自变量,性别、年龄和调查年份为协变量,建立多重线性回归模型。结果显示:在婚(β=2.33,P<0.001)、每周1~2次饮酒(β=−1.42,P<0.05)、四周内患病(β=−2.57,P<0.001)、最近一年住院(β=−1.82,P<0.05)、工资拖欠(β=−1.67,P<0.05)、工作满意度(β=1.25,P<0.001)、月住房花费(住房花费低于月收入:β=−1.55,P=0.001;住房花费高于月收入:β=−4.59,P=0.001)以及住房条件(β=0.23,P<0.05)对乡城流动人口MCS的影响均具有统计学意义。Oaxaca-Blinder分解法结果显示:以2018年为基准,前后两次调查的MCS差异为(−4.7660分),可解释的部分占15.80%。其中在婚、四周内患病率降低以及工作满意度评分上升对成都市乡城流动人口心理健康改善产生了正向贡献,有月住房花费的比例增加产生了负向贡献。
      结论  从2009年到2018年,成都市乡城流动人口的心理健康有所改善,期间流动人口婚姻状况、四周内患病情况、工作满意度以及月住房花费的变化对其心理健康提升做出了贡献。今后在制定促进流动人口心理健康的干预措施时,可从健康社会决定因素的角度考虑。

     

    Abstract:
      Objective  To investigate the social determinants that influenced the changes in the mental health of the rural-urban migrant population in Chengdu.
      Methods  Using data from two cross-sectional surveys, one conducted in 2009 and another, in 2018, of the rural-urban migrant population in Chengdu, we analyzed the social determinants of mental health affecting the rural-urban migrant population in Chengdu by multiple linear regression, and analyzed the contribution of changes in social determinants to the disparity in mental health over a decade using the Oaxaca-Blinder decomposition analysis.
      Results  This study included 3091 cases of rural-urban migrants in Chengdu, with 965 (31.22%) covered in the survey year of 2009 and 2126 (68.78%) covered in 2018. Multiple linear regression models were established with mental component summary (MCS) as the dependent variable, the social determinants of health as the independent variables, and gender, age, and survey year as covariates. The findings showed that being married (β=2.33, P<0.001), drinking 1-2 times per week (β=−1.42, P<0.05), illness within four weeks (β=−2.57, P<0.001), and hospitalization in the past year (β=−1.82, P<0.05), wage arrears (β=−1.67, P<0.05), job satisfaction (β=1.25, P<0.001), monthly housing costs (housing costs below monthly income: β=−1.55, P=0.001; housing costs above monthly income: β=−4.59, P=0.001) and housing condition (β=0.23, P<0.05) had significant impact on the MCS of the rural-urban migrant population. The results of the Oaxaca-Blinder decomposition method showed that the MCS disparity between the two surveys was −4.7660 points. With 2018 as the base year, the explainable parts accounted for 15.80%. Being married, decrease in the prevalence of illnesses within four weeks, and increased job satisfaction formed positive contribution to the improvement of the mental health, and increase in the proportion of monthly housing expenses formed negative contribution.
      Conclusion  Between 2009 and 2018, the mental health of the rural-urban migrant population in Chengdu showed improvement, and changes in marital status, illness within four weeks, job satisfaction, and monthly housing costs contributed to improvements in mental health during the period. Future intervention measures to promote the mental health of the floating population can be developed with the perspective of improving the social determinants of health in mind.

     

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