雪上加霜?JAMA:“钱没了”会增加死亡风险
2018/04/07
“巨大的经济损失,会增加中老年人的死亡风险”——这是美国西北大学、密歇根大学的科学家们最新的研究结论。他们发现,两年内失去75%或者更多的资产,当事人在接下来的20年内的死亡风险会增加50%。


图片来源:CC0 Public Domain

4月3日,JAMA期刊发表了这一篇题为“Association of a Negative Wealth Shock With All-Cause Mortality in Middle-aged and Older Adults in the United States”的文章,首次探讨了巨大经济损失对健康的长期影响

文章一作、美国西北大学Feinberg医学院预防医学研究助理教授Lindsay Pool认为,“失去积蓄会显著影响长期健康”这一最新研究反映了一个非常普遍的问题。这不仅仅局限于少数人,因为过去20年超25%的美国人遭受了严重的经济冲击。

“我们的发现揭示了一个影响健康的社会因素——中年及以上年纪的人突然失去积蓄,这是一个迄今为止未被重视的点。”文章通讯作者、密歇根大学公共卫生学院流行病学和全球公共卫生教授Carlos Mendes de Leon强调道。


doi:10.1001/jama.2018.2055

“钱没了”、“没有钱”一样糟糕

这一最新研究基于之前一项针对2007年至2010年初美国经济大衰退之后的调研结果,包括经济状况改变对于健康的短期影响(抑郁、血压、压力等)。西北大学的研究团队共分析了超8000名参与者的数据。Pool认为,这些结果意味着,临床医生需要了解患者的财务状况。

这项研究还调研了一群没有资产的低收入人群,他们在健康方面被认为是社会弱势群体。结果显示,过去20年,他们的死亡风险增加了67%。

“最让人惊讶的是,失去已拥有的财富对于预期寿命的负面影响几乎和没有财富一样糟糕。” Pool解释道。

为什么死亡风险会增加?

关于死亡风险增加,研究人员推测有两个主要原因——首先,因为经济上的损失导致精神受创;其次,无力承担医疗费用,包括支付医疗保险。

下一步,研究团队将会继续探究巨大经济损失导致更高死亡率的机制。Pool希望能够从中找到干预措施,从而减缓风险增加的进程。

责编:悠然

参考资料:

People have a 50 percent higher risk of death if they suffer a shocking financial loss

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  • Association of a Negative Wealth Shock With All-Cause Mortality in Middle-aged and Older Adults in the United States

    Importance A sudden loss of wealth—a negative wealth shock—may lead to a significant mental health toll and also leave fewer monetary resources for health-related expenses. With limited years remaining to regain lost wealth in older age, the health consequences of these negative wealth shocks may be long-lasting. Objective To determine whether a negative wealth shock was associated with all-cause mortality during 20 years of follow-up. Design, Setting, and Participants The Health and Retirement Study, a nationally representative prospective cohort study of US adults aged 51 through 61 years at study entry. The study population included 8714 adults, first assessed for a negative wealth shock in 1994 and followed biennially through 2014 (the most recent year of available data). Exposures Experiencing a negative wealth shock, defined as a loss of 75% or more of total net worth over a 2-year period, or asset poverty, defined as 0 or negative total net worth at study entry. Main Outcomes and Measures Mortality data were collected from the National Death Index and postmortem interviews with family members. Marginal structural survival methods were used to account for the potential bias due to changes in health status that may both trigger negative wealth shocks and act as the mechanism through which negative wealth shocks lead to increased mortality. Results There were 8714 participants in the study sample (mean [SD] age at study entry, 55 [3.2] years; 53% women), 2430 experienced a negative wealth shock during follow-up, 749 had asset poverty at baseline, and 5535 had continuously positive wealth without shock. A total of 2823 deaths occurred during 80 683 person-years of follow-up. There were 30.6 vs 64.9 deaths per 1000 person-years for those with continuously positive wealth vs negative wealth shock (adjusted hazard ratio [HR], 1.50; 95% CI, 1.36-1.67). There were 73.4 deaths per 1000 person-years for those with asset poverty at baseline (adjusted HR, 1.67; 95% CI, 1.44-1.94; compared with continuously positive wealth). Conclusions and Relevance Among US adults aged 51 years and older, loss of wealth over 2 years was associated with an increased risk of all-cause mortality. Further research is needed to better understand the possible mechanisms for this association and determine whether there is potential value for targeted interventions.

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