文章基本信息

标题：Poverty, Race/Ethnicity, and Psychiatric Disorder: A Study of Rural Children
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作者：E. Jane Costello ; Gordon P. Keeler ; Adrian Angold 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2001
卷号：91
期号：9
页码：1494-1498
语种：English
出版社：American Public Health Association
摘要：Objectives. This study examined the effect of poverty on the prevalence of psychiatric disorder in rural Black and White children. Methods. A representative sample of 541 Black children and 379 White children aged 9 to 17 was drawn from 4 predominantly rural counties. Structured interviews with parents and children collected information on psychiatric disorders, absolute and relative poverty, and risk factors for psychiatric disorder. Results. Three-month prevalence of psychiatric disorder was similar to that found in other community samples (20%). Federal criteria for poverty were met by 18% of the White and 52% of the Black families. Black and White children were exposed to equal numbers of risk factors overall, but the association between poverty and psychopathology was stronger for White children (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1, 4.2) than for Black children (OR = 1.5; 95% CI = 0.9, 2.6). Family history of mental illness, poor parenting, and residential instability mediated this association in both groups. Conclusions. In this rural sample, poverty was only weakly associated with child psychiatric disorders. Risk factors for both racial/ethnic groups were family mental illness, multiple moves, lack of parental warmth, lax supervision, and harsh punishment. Poverty can endanger children's mental health 1 ^– 3 through exposure to a range of adversities. These may include poor housing; homelessness; multiple moves from one dwelling (and often school) to another; lack of health insurance 4 ^, 5 ; and the stress that parents experience while raising a family in poverty, which can lead to harsh or noncontingent punishment, deficient parental supervision, or lack of warmth and love. 2 ^, 6 Several researchers, who noted the high levels of psychiatric symptoms in minority children living in inner-city areas, have argued that the urban environment, 7 ^– 9 minority status, 10 or both together are harmful to emotional and behavioral development (but see Farrow and Schwartz 11 ). An associated argument is that poor families are more likely to live in impoverished neighborhoods, with poor schools, antisocial peer groups, and little “social capital.” 12 ^– 14 The literature on social selection 15 argues that families may become or remain poor because they lack the personal resources—mental health, education, social connections—to climb out of poverty. In an extension to this position, Dohrenwend et al. 16 has shown that poverty also may be damaging when it puts families in a position of relative deprivation compared with others whom they regard as their natural comparison group. 17 Clearly, many of these mechanisms could co-occur. The goals of this study were (1) to compare the prevalence of psychiatric disorders in nonurban poor and nonpoor Black and White children, (2) to compare the types and numbers of family risk factors for child psychopathology in poor and nonpoor Black and White families, and (3) to examine the effects of the interaction of poverty and minority status on child psychopathology.