Psychosocial factors and public health: a suitable case for treatment?

被引:156
作者
Macleod, J [1 ]
Smith, GD
机构
[1] Univ Birmingham, Dept Primary Care & Gen Practice, Birmingham B15 2TT, W Midlands, England
[2] Univ Bristol, Dept Social Med, Bristol BS8 1TH, Avon, England
关键词
D O I
10.1136/jech.57.8.565
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Adverse psychosocial exposure or "misery" is associated with physical disease. This association may not be causal. Rather it may reflect issues of reverse causation, reporting bias, and confounding by aspects of the material environment typically associated with misery. A non-causal relation will not form the basis of effective public health interventions. This may be why psychosocial interventions have, so far, showed little effect on objective physical health outcomes. This paper reviews evidence for the "psychosocial hypothesis" and suggests strategies for clarifying these issues. It concludes that, although misery is clearly a bad thing as it erodes people's quality of life, there is little evidence that psychosocial factors cause physical disease. In the absence of better evidence, suggestions that psychosocial interventions are needed to improve population physical health, in both absolute and relative terms, seem premature.
引用
收藏
页码:565 / 570
页数:6
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