Study of resilience and environmental adversity in midlife health (STREAM).

Eva Velthorst,Abraham Reichenberg,Jonathan Rabinowitz,Stephen Z Levine

doi:10.1007/s00127-015-1126-y

Abstract

PurposeThe Jerusalem study of resilience and environmental adversity in midlife health (STREAM) was established to examine the prevalence of common mental and physical health issues in mid-adulthood in the inner city of Jerusalem, and to examine their association with lifespan psychosocial factors of vulnerability and resilience.MethodParticipants were 811 randomly selected individuals from 7000 individuals who were born and grew up in inner-Jerusalem. Participants were 34–44 years old during first wave of STREAM assessment. Initial telephone surveys took place in 2007–2008 and participants were followed-up for a second survey 1 year later. Upon funding, a new wave is planned for 2017–2018. Survey topics comprised common health problems (e.g., type 2 diabetes/migraine), health markers (e.g., BMI), and psychiatric vulnerabilities (e.g., anxiety, post-traumatic stress, depressive symptoms, psychosis). Other measures included socioeconomic status, creativity, life style behavior (e.g., smoking, exercise), social contact and adaptation to change. Survey data were retrospectively merged with data of national registry sources that included adverse psychosocial factors, psychiatric and social measures assessed across all developmental stages through midlife. This includes data available on birth factors, school achievement and adjustment, cognitive and behavioral functioning during young adulthood, psychiatric hospitalizations, immigration and socioeconomic status.ResultsResults on health outcomes of the first STREAM wave indicate that prevalence rates of health problems are comparable to recent World Mental Health Surveys.ConclusionsApart from measures on adverse psychosocial factors, STREAM provides a cohort to examine resilience to developing health problems and having a poor health and functional outcome.Electronic supplementary materialThe online version of this article (doi:10.1007/s00127-015-1126-y) contains supplementary material, which is available to authorized users.

Highlights

Inner-city populations, such as inner-Jerusalem, are at increased risk of developing mental disorders and health problems during adulthood [1,2,3,4,5]
Results on health outcomes of the first STREAM wave indicate that prevalence rates of health problems are comparable to recent World Mental Health Surveys
STREAM is an Israeli national cohort study to actively follow-up a representative sample of adults by linking both in-depth surveys to the wealth of national registries including data on different times across the lifespan

Summary

Introduction

Inner-city populations, such as inner-Jerusalem, are at increased risk of developing mental disorders and health problems during adulthood [1,2,3,4,5]. The primary objective of the study of resilience and environmental adversity in midlife health (STREAM) was to explore psychosocial factors that could predict unfavorable health outcome in inner cities. STREAM is an Israeli national cohort study to actively follow-up a representative sample of adults by linking both in-depth surveys to the wealth of national registries including data on different times across the lifespan. Our goal was to extend existing knowledge on psychosocial factors associated with adverse outcomes in inner-city areas, and to explore social and developmental mechanisms underlying resilience to developing health problems, mechanisms that might be key to the development of optimal interventions in high-risk populations. There is growing recognition of the importance of studying resilience [7], cohort studies far predominantly focused on factors of risk and vulnerability

Objectives

Methods

Results