wow-inequalities/02-data/intermediate/wos_sample/3767df73714702039d432d1d0537b788-singh-parvati/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background: Research examining mental health outcomes following economic
downturns finds both pro-cyclic and countercyclic associations.
Pro-cyclic findings (i.e. economic downturns correspond with decline in
illnesses) invoke increase in leisure time and risk-averse behavior as
underlying drivers of reduction in harmful consumption during economic
recessions. By contrast, counter-cyclic evidence (i.e. economic
downturns correspond with increase in illnesses) suggests increase in
mental illness with economic decline owing to heightened stress and loss
of resources. particularly among certain age and socioeconomic groups.
Aim of the Study: To examine the relation between monthly aggregate
employment decline and psychiatric emergency department visits across 96
counties within 49 Metropolitan Statistical Areas in the United States.
Methods: For this study, data on all psychiatric outpatient Emergency
Department (ED) visits for 4 US states (Arizona, California, New Jersey
and New York) were retrieved from the State Emergency Department
Database (SEDD) and aggregated by county-month, for the time period of
2006 to 2011. Exposure to recession was operationalized as
population-level employment change in a Metropolitan Statistical Area
(MSA). This information was obtained from MSA-level employment provided
by the US Bureau of Labor Statistics. Brief exposure time lags of 0 to 3
months were specified to estimate proximate responses to MSA-level
economic decline. Income level was approximated based on insurance
status (private insurance= high-income, public insurance = low-income).
Linear regression analysis was used to test whether monthly decline in
aggregate employment in an MSA corresponds with (i) changes in
population rates of psychiatric ED visits and (ii) whether the relation
between the outcome and exposure varies by insurance status (private,
public) and age group (children. age < 20 years; working-age adults, age
20 to 64 years; elderly adults, age > 64 years). Regression methods
controlled for region. year and month fixed effects, and state-specific
linear time trends.
Results: Linear regression results indicate that overall, psychiatric ED
visits (per 100,000 population) decline with decline in monthly
employment at exposure lag 0 (coefficient: 0.54, p < 0.001) and lag 2
(coefficient: 0.52, p < 0.001). Privately insured (high-income) groups
also show a decline in psychiatric ED visits following decline in
aggregate employment. Conversely, publicly insured children show an
increase in psychiatric ED visit rates one month (i.e. lag 1) following
employment decline (coefficient: -0.35, p value < 0.01). Exploratory
analyses by disorder groups show that the population-level decline in
psychiatric ED visits concentrates among visits for alcohol use
disorders at 0, 1 and 2 month lags of employment decline.
Discussion: This study''s findings provide evidence of pro- as well as
counter-cyclic trends in psychiatric emergency visits following
aggregate employment decline in an MSA. Whereas declines in psychiatric
emergencies support a risk-averse response to economic recessions, these
aggregate trends may mask countervailing trends among vulnerable groups.
Limitations of this study include the absence of sex-specific analyses
and lack of information on emergent or non-emergent nature of
psychiatric ED visits.
Implications for Health Care Provision and Use: Psychiatric ED visits
during recessions may vary by age and income groups.
Implications for Health Policies: Findings from this study may serve to
develop targeted policies for low-income groups during macroeconomic
downturns.
Implications for Further Research: Future research may examine trends in
emergent versus non-emergent psychiatric ED visits following economic
recessions.'
affiliation: 'Singh, P (Corresponding Author), Univ Calif Irvine, Program Publ Hlth,
Anteater Instruct \& Res Off AIRB, 653 E Peltason Dr Suite 2010,2nd Floor, Irvine,
CA 92697 USA.
Singh, Parvati, Univ Calif Irvine, Program Publ Hlth, Anteater Instruct \& Res Off
AIRB, 653 E Peltason Dr Suite 2010,2nd Floor, Irvine, CA 92697 USA.'
author: Singh, Parvati
author-email: parvatis@uci.edu
author_list:
- family: Singh
given: Parvati
da: '2023-09-28'
eissn: 1099-176X
files: []
issn: 1091-4358
journal: JOURNAL OF MENTAL HEALTH POLICY AND ECONOMICS
keywords-plus: 'MENTAL-HEALTH-SERVICES; GREAT RECESSION; TIME-SERIES; UNEMPLOYMENT;
ANTECEDENTS; DISPARITIES; DEPRESSION; ACT'
language: English
month: MAR
number: '1'
number-of-cited-references: '66'
pages: 13-30
papis_id: e43e63e7ad9e9c23fc7f2df56673c80e
ref: Singh2021psychiatricemergenci
times-cited: '0'
title: 'Psychiatric Emergencies Following the 2008 Economic Recession: An Ecological
Examination of Population-Level Responses in Four US States'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000626637300003
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '24'
web-of-science-categories: Health Policy \& Services; Psychiatry
year: '2021'