中学生药物滥用行为及其影响因素的地域差异
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摘要
青少年的健康状况尤其是健康行为,往往会延续至成年时期,同时,相比于成年人,青少年的药物滥用对其大脑的危害更大,更易导致成瘾。中学生是青少年的主要群体,研究其药物滥用行为的影响因素及机制,有助于实施干预措施,减少其健康风险。以往文献对中学生药物滥用行为的研究较为全面,但对学校周边的建成环境以及地域差异引起个体健康行为差异背后的原因关注不足。以随机抽取的广东省124所初级中学为研究对象,并基于2010年各区县的人口普查数据,通过因子生态分析方法划分抽样学校所在区县的社会区类型,分析位于不同社会区的中学生药物滥用情况,而后运用多元逐步回归模型,探究中学生药物滥用行为影响因素的地域差异。结果表明,不同社会区的中学生药物滥用行为发生率存在差异,年轻化的外来人口集聚地区中学生药物滥用发生率最高,其次为人口老龄化地区,社会环境相对稳定的本地商业从业人员集聚地区最低。在年轻化的外来人口聚集地区中,课外到网吧、游戏厅、台球室活动学生的高比例与学校1000 m范围内的网吧、游艺室的高密度等外部环境容易导致学校中学生药物滥用的高发;在人口老龄化地区中,道路交叉口的高密度等建成环境表征了良好的社会监督,有助于降低学生滥用药物的风险;在本地商业从业人员聚集地区中,融洽的家庭关系有利于制约中学生滥用药物,同时零花钱越高,中学生购买药物的机会越大,因而越容易发生药物滥用行为。
The research on adolescents' health is one of the main topics in the field of health geography. The health problems in one's teen age tend to have some potential influence in his adulthood, especially the health behaviors. Compared to adult, drug abuse of a teenager is more harmful to one's brain and more likely to lead to addiction. The study of factors that affect drug abuse among middle school students, will contribute to interventions introducing and health risks reducing. Previous researches focused on the factors that lead to drug abuse, including individual, neighborhood and regional factors. But less literature focused on the surrounding built environment of schools or studied the mechanism leading to the differences in the health behavior of different regions. This paper tries to fill in the gaps by a case study of 124 middle schools in Guangdong province, China. Using the factorial ecological analysis and cluster analysis to explore the social spatial structure of the districts in which sample schools located,as well as the multiple stepwise regression models, this paper explores the situation and factors that affect middle school students' drug abuse in different social areas. The results reveal that there are differences in the incidence of drug abuse among middle school students in different social areas. The incidence of young floating population gathering areas is the highest,followed by the aging areas. And the local business practitioners gathering areas have the lowest incidence. In the young floating population gathering areas, built and social environments such as the high proportion of students who would go to internet bars, game centers, and billiard parlors in their free time, as well as the high density of internet bars and game centers within 1000 m around the school, will cause a high incidence of drug abuse among school students. In the aging areas, characterizing good social supervision, the built environment such as the high density of intersections helps to reduce the risk of drug abuse among students. In the local business practitioners gathering areas, family factors such as harmonious family relationship help to reduce drug abuse among students. Meanwhile, if middle school students have more pocket money, they have more chances to buy drugs, and are more likely to suffer from the drug abuse.
The research on adolescents' health is one of the main topics in the field of health geography. The health problems in one's teen age tend to have some potential influence in his adulthood, especially the health behaviors. Compared to adult, drug abuse of a teenager is more harmful to one's brain and more likely to lead to addiction. The study of factors that affect drug abuse among middle school students, will contribute to interventions introducing and health risks reducing. Previous researches focused on the factors that lead to drug abuse, including individual, neighborhood and regional factors. But less literature focused on the surrounding built environment of schools or studied the mechanism leading to the differences in the health behavior of different regions. This paper tries to fill in the gaps by a case study of 124 middle schools in Guangdong province, China. Using the factorial ecological analysis and cluster analysis to explore the social spatial structure of the districts in which sample schools located,as well as the multiple stepwise regression models, this paper explores the situation and factors that affect middle school students' drug abuse in different social areas. The results reveal that there are differences in the incidence of drug abuse among middle school students in different social areas. The incidence of young floating population gathering areas is the highest,followed by the aging areas. And the local business practitioners gathering areas have the lowest incidence. In the young floating population gathering areas, built and social environments such as the high proportion of students who would go to internet bars, game centers, and billiard parlors in their free time, as well as the high density of internet bars and game centers within 1000 m around the school, will cause a high incidence of drug abuse among school students. In the aging areas, characterizing good social supervision, the built environment such as the high density of intersections helps to reduce the risk of drug abuse among students. In the local business practitioners gathering areas, family factors such as harmonious family relationship help to reduce drug abuse among students. Meanwhile, if middle school students have more pocket money, they have more chances to buy drugs, and are more likely to suffer from the drug abuse.
引文
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[3]Ji Chengye.Adolescent health risk behavior.Chinese Journal School Health,2007,28(4):289-291.[季成叶.青少年健康危险行为.中国学校卫生,2007,28(4):289-291.]
[4]Peng Dongyong,Chen Jingshan,Qiu Jincui,et al.Analysis of causes and status quo of smoking,drinking and drug abuse among college and middle school students in Guangzhou.Practical Preventive Medicine,2007,14(5):1368-1370.[彭东泳,陈静珊,丘金翠,等.广州市大、中学生吸烟、饮酒及药物滥用现状及原因分析.实用预防医学,2007,14(5):1368-1370.]
[5]Sun Wenlin,Li Mi,Liu Zhimin,et al.Self-reported psychoactive drug use by students at three universities in Beijing.Chin Bull Drug Depend,1993(2):119.[孙文林,李密,刘志民,等.北京三所高校学生使用精神活性药物情况调查.中国药物依赖性杂志,1993(2):119.]
[6]Levin K A,Dundas R,Miller,M,et al.Socioeconomic and geographic inequalities in adolescent smoking:A multilevel cross-sectional study of 15 year olds in Scotland.Social Science&Medicine,2014,107(100):162.
[7]Mcleroy K R,Bibeau D,Steckler A,et al.An ecological perspective on health promotion programs.Health Education&Behavior,1988,15(4):351-377.
[8]Bronfenbrenner U.Toward an experimental ecology of human development.American Psychologist,1977,32(32):513-531.
[9]Zarrouq B,Bendaou B,Asri A E,et al.Psychoactive substances use and associated factors among middle and high school students in the North Center of Morocco:A cross-sectional questionnaire survey.BMC Public Health,2016,16(1):1-9.
[10]Mccabe S E,Knight J R,Teter C J,et al.Non-medical use of prescription stimulants among US college students:Prevalence and correlates from a national survey.Addiction,2005,100(1):96-106.
[11]Spilkova J,Dzúrova D,Pitonak M.Perception of neighborhood environment and health risk behaviors in Prague's teenagers:A pilot study in a post-communist city.International Journal of Health Geographics,2014,13(1):41.
[12]Wiehe S E,Kwan M P,Wilson J,et al.Adolescent health-risk behavior and community disorder.Plos One,2013,8(11):e77667.
[13]Crum R M,Lillie-Blanton M,Anthony J C.Neighborhood environment and opportunity to use cocaine and other drugs in late childhood and early adolescence.Drug&Alcohol Dependence,1996,43(3):155.
[14]CerdáM,Ransome Y,Keyes K M,et al.Revisiting the role of the urban environment in substance use:The case of analgesic overdose fatalities.American Journal of Public Health,2013,103(12):2252-2260.
[15]Akhtar P C,Haw S J,Levin K A,et al.Socioeconomic differences in second-hand smoke exposure among children in Scotland after introduction of the smoke-free legislation.Journal of Epidemiology&Community Health,2010,64(4):341-346.
[16]Krieger J,Higgins D L.Housing and health:Time again for public health action.American Journal of Public Health,2002,92(5):758-768.
[17]Handy S L,Boarnet M G,Ewing R,et al.How the built environment affects physical activity:Views from urban planning.American Journal of Preventive Medicine,2002,23(Suppl.2):64-73.
[18]Cohen D A,Inagami S,Finch B.The built environment and collective efficacy.Health&Place,2008,14(2):198-208.
[19]Hembree C,Galea S,Ahern J,et al.The urban built environment and overdose mortality in New York City neighborhoods.Health&Place,2005,11(2):147-156.
[20]Galea S,Rudenstine S,Vlahov D.Drug use,misuse,and the urban environment.Drug and Alcohol Review,2005,24(2):127-136.
[21]Rhodes J E,Jason L A.A social stress model of substance abuse.Journal of Consulting&Clinical Psychology,1990,58(4):395-401.
[22]Lindenberg C S,Reiskin H K,Gendrop S C.The social stress model of substance abuse among childbearing-age women:A review of the literature.Journal of Drug Education,1994,24(3):253-268.
[23]West J H,Blumberg E J,Kelley N J,et al.Does proximity to retailers influence alcohol and tobacco use among Latino adolescents?Journal of Immigrant and Minority Health,2010,12(5):626.
[24]Milam A J,Johnson S L,Furrholden C D M,et al.Alcohol outlets and substance use among high schoolers.Journal of Community Psychology,2016,44(7):819-832.
[25]Zenk S N,Schulz A J,Matthews S A,et al.Activity space environment and dietary and physical activity behaviors:A pilot study.Health&Place,2011,17(5):1150-1161.
[26]Leatherdale S T,Manske S.The relationship between student smoking in the school environment and smoking onset in elementary school students.Cancer Epidem Biomar,2005,14(14):1762-1765.
[27]Veitch C.Impact of rurality on environmental determinants and hazards.Australian Journal of Rural Health,2009,17(1):16-20.
[28]Slaunwhite A K.Development of a community index of alcohol-related harm for British Columbia,Canada.Applied Geography,2015,62:267-275.
[29]Roncero C,Egido A,Rodríguezcintas L,et al.Substance use among medical students:A literature review 1988-2013.Actas Esp Psiquiatri,2015,43(3):109-121.
[30]Wang H,Deng J,Zhou X,et al.The nonmedical use of prescription medicines among high school students:A crosssectional study in southern China.Drug&Alcohol Dependence,2014,141:9-15.
[31]Chaney R A,Rojas-Guyler L.Spatial patterns of adolescent drug use.Applied Geography,2015,56:71-82.
[32]Wang Wanxin,Deng Jianxiong,Guo Lan,et al.Psychoactive drug use for non-medical purpose among middle school students in Guangdong province.Chinese Journal of Public Health,2015,31(7):856-858.[王婉馨,邓剑雄,郭蓝,等.广东中学生非医疗目的使用精神活性药物情况调查.中国公共卫生,2015,31(7):856-858.]
[33]Xu Xueqiang,Hu Huayin,Ye Jia'an.A factorial ecological study of social spatial structure in Guangzhou.Acta Geographica Sinica,1989,44(4):385-399.[许学强,胡华颖,叶嘉安.广州市社会空间结构的因子生态分析.地理学报,1989,44(4):385-399.]
[34]Zhou Chunshan,Hu Jincan,Tong Xinmei,et al.The socio-spatial structure of Guangzhou and its evolution.Acta Geographyica Sinica,2016,71(6):1010-1024.[周春山,胡锦灿,童新梅,等.广州市社会空间结构演变跟踪研究.地理学报,2016,71(6):1010-1024.]
[35]Yuan Yuan,Xu Xueqiang.Residential segregation of floating population and driving forces in Guangzhou city.Human Geography,2008,23(5):61-66.[袁媛,许学强.广州市外来人口居住隔离及影响因素研究.人文地理,2008,23(5):61-66.]
[36]Jacobs Jane.The death and life of great American cities:Yilin Press,2006:424.[简·雅各布斯.美国大城市的死与生:译林出版社,2006:424.]
[37]Sun Bindong,Dan Bo.Impact of urban built environment on residential choice of commuting mode in Shanghai.Acta Geographica Sinica,2015,70(10):1664-1674.[孙斌栋,但波.上海城市建成环境对居民通勤方式选择的影响.地理学报,2015,70(10):1664-1674.]
(1)由国家药物滥用监测中心2009年发布。
(2)中华人民共和国住房和城乡建设部与中华人民共和国国家质量监督检验检疫总局联合发布。
[2]Liu Xiaoxia,Zhou Xiaohua,Wang Xingzhong.Progress of health geography in western countries.Human Geography,2012,27(3):23-27.[刘晓霞,邹小华,王兴中.国外健康地理学研究进展.人文地理,2012,27(3):23-27.]
[3]Ji Chengye.Adolescent health risk behavior.Chinese Journal School Health,2007,28(4):289-291.[季成叶.青少年健康危险行为.中国学校卫生,2007,28(4):289-291.]
[4]Peng Dongyong,Chen Jingshan,Qiu Jincui,et al.Analysis of causes and status quo of smoking,drinking and drug abuse among college and middle school students in Guangzhou.Practical Preventive Medicine,2007,14(5):1368-1370.[彭东泳,陈静珊,丘金翠,等.广州市大、中学生吸烟、饮酒及药物滥用现状及原因分析.实用预防医学,2007,14(5):1368-1370.]
[5]Sun Wenlin,Li Mi,Liu Zhimin,et al.Self-reported psychoactive drug use by students at three universities in Beijing.Chin Bull Drug Depend,1993(2):119.[孙文林,李密,刘志民,等.北京三所高校学生使用精神活性药物情况调查.中国药物依赖性杂志,1993(2):119.]
[6]Levin K A,Dundas R,Miller,M,et al.Socioeconomic and geographic inequalities in adolescent smoking:A multilevel cross-sectional study of 15 year olds in Scotland.Social Science&Medicine,2014,107(100):162.
[7]Mcleroy K R,Bibeau D,Steckler A,et al.An ecological perspective on health promotion programs.Health Education&Behavior,1988,15(4):351-377.
[8]Bronfenbrenner U.Toward an experimental ecology of human development.American Psychologist,1977,32(32):513-531.
[9]Zarrouq B,Bendaou B,Asri A E,et al.Psychoactive substances use and associated factors among middle and high school students in the North Center of Morocco:A cross-sectional questionnaire survey.BMC Public Health,2016,16(1):1-9.
[10]Mccabe S E,Knight J R,Teter C J,et al.Non-medical use of prescription stimulants among US college students:Prevalence and correlates from a national survey.Addiction,2005,100(1):96-106.
[11]Spilkova J,Dzúrova D,Pitonak M.Perception of neighborhood environment and health risk behaviors in Prague's teenagers:A pilot study in a post-communist city.International Journal of Health Geographics,2014,13(1):41.
[12]Wiehe S E,Kwan M P,Wilson J,et al.Adolescent health-risk behavior and community disorder.Plos One,2013,8(11):e77667.
[13]Crum R M,Lillie-Blanton M,Anthony J C.Neighborhood environment and opportunity to use cocaine and other drugs in late childhood and early adolescence.Drug&Alcohol Dependence,1996,43(3):155.
[14]CerdáM,Ransome Y,Keyes K M,et al.Revisiting the role of the urban environment in substance use:The case of analgesic overdose fatalities.American Journal of Public Health,2013,103(12):2252-2260.
[15]Akhtar P C,Haw S J,Levin K A,et al.Socioeconomic differences in second-hand smoke exposure among children in Scotland after introduction of the smoke-free legislation.Journal of Epidemiology&Community Health,2010,64(4):341-346.
[16]Krieger J,Higgins D L.Housing and health:Time again for public health action.American Journal of Public Health,2002,92(5):758-768.
[17]Handy S L,Boarnet M G,Ewing R,et al.How the built environment affects physical activity:Views from urban planning.American Journal of Preventive Medicine,2002,23(Suppl.2):64-73.
[18]Cohen D A,Inagami S,Finch B.The built environment and collective efficacy.Health&Place,2008,14(2):198-208.
[19]Hembree C,Galea S,Ahern J,et al.The urban built environment and overdose mortality in New York City neighborhoods.Health&Place,2005,11(2):147-156.
[20]Galea S,Rudenstine S,Vlahov D.Drug use,misuse,and the urban environment.Drug and Alcohol Review,2005,24(2):127-136.
[21]Rhodes J E,Jason L A.A social stress model of substance abuse.Journal of Consulting&Clinical Psychology,1990,58(4):395-401.
[22]Lindenberg C S,Reiskin H K,Gendrop S C.The social stress model of substance abuse among childbearing-age women:A review of the literature.Journal of Drug Education,1994,24(3):253-268.
[23]West J H,Blumberg E J,Kelley N J,et al.Does proximity to retailers influence alcohol and tobacco use among Latino adolescents?Journal of Immigrant and Minority Health,2010,12(5):626.
[24]Milam A J,Johnson S L,Furrholden C D M,et al.Alcohol outlets and substance use among high schoolers.Journal of Community Psychology,2016,44(7):819-832.
[25]Zenk S N,Schulz A J,Matthews S A,et al.Activity space environment and dietary and physical activity behaviors:A pilot study.Health&Place,2011,17(5):1150-1161.
[26]Leatherdale S T,Manske S.The relationship between student smoking in the school environment and smoking onset in elementary school students.Cancer Epidem Biomar,2005,14(14):1762-1765.
[27]Veitch C.Impact of rurality on environmental determinants and hazards.Australian Journal of Rural Health,2009,17(1):16-20.
[28]Slaunwhite A K.Development of a community index of alcohol-related harm for British Columbia,Canada.Applied Geography,2015,62:267-275.
[29]Roncero C,Egido A,Rodríguezcintas L,et al.Substance use among medical students:A literature review 1988-2013.Actas Esp Psiquiatri,2015,43(3):109-121.
[30]Wang H,Deng J,Zhou X,et al.The nonmedical use of prescription medicines among high school students:A crosssectional study in southern China.Drug&Alcohol Dependence,2014,141:9-15.
[31]Chaney R A,Rojas-Guyler L.Spatial patterns of adolescent drug use.Applied Geography,2015,56:71-82.
[32]Wang Wanxin,Deng Jianxiong,Guo Lan,et al.Psychoactive drug use for non-medical purpose among middle school students in Guangdong province.Chinese Journal of Public Health,2015,31(7):856-858.[王婉馨,邓剑雄,郭蓝,等.广东中学生非医疗目的使用精神活性药物情况调查.中国公共卫生,2015,31(7):856-858.]
[33]Xu Xueqiang,Hu Huayin,Ye Jia'an.A factorial ecological study of social spatial structure in Guangzhou.Acta Geographica Sinica,1989,44(4):385-399.[许学强,胡华颖,叶嘉安.广州市社会空间结构的因子生态分析.地理学报,1989,44(4):385-399.]
[34]Zhou Chunshan,Hu Jincan,Tong Xinmei,et al.The socio-spatial structure of Guangzhou and its evolution.Acta Geographyica Sinica,2016,71(6):1010-1024.[周春山,胡锦灿,童新梅,等.广州市社会空间结构演变跟踪研究.地理学报,2016,71(6):1010-1024.]
[35]Yuan Yuan,Xu Xueqiang.Residential segregation of floating population and driving forces in Guangzhou city.Human Geography,2008,23(5):61-66.[袁媛,许学强.广州市外来人口居住隔离及影响因素研究.人文地理,2008,23(5):61-66.]
[36]Jacobs Jane.The death and life of great American cities:Yilin Press,2006:424.[简·雅各布斯.美国大城市的死与生:译林出版社,2006:424.]
[37]Sun Bindong,Dan Bo.Impact of urban built environment on residential choice of commuting mode in Shanghai.Acta Geographica Sinica,2015,70(10):1664-1674.[孙斌栋,但波.上海城市建成环境对居民通勤方式选择的影响.地理学报,2015,70(10):1664-1674.]
(1)由国家药物滥用监测中心2009年发布。
(2)中华人民共和国住房和城乡建设部与中华人民共和国国家质量监督检验检疫总局联合发布。