Social Psychiatry and Psychiatric Epidemiology
Volume 54, Issue 2, 2019, Pages 157-170

The relationship between neighborhood-level socioeconomic characteristics and individual mental disorders in five cities in Latin America: multilevel models from the World Mental Health Surveys (Article)

Sampson L.* , Martins S.S. , Yu S. , Chiavegatto Filho A.D.P. , Andrade L.H. , Viana M.C. , Medina-Mora M.E. , Benjet C. , Torres Y. , Piazza M. , Aguilar-Gaxiola S. , Cia A.H. , Stagnaro J.C. , Zaslavsky A.M. , Kessler R.C. , Galea S.
  • a Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, United States
  • b Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, United States
  • c Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, United States
  • d Department of Epidemiology, School of Public Health of the University of São Paulo, 715 Av Dr Arnaldo, São Paulo, 01246-904, Brazil
  • e Nucleo de Epidemiologia Psiquiatrica LIM-23, Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, Rua Dr. Ovidio Pires de Campos, 785, São Paulo, 05403-010, Brazil
  • f Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espirito Santo, Av. Mal. Campos, 1355, Vitória, Espirito Santo 29043-260, Brazil
  • g Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Calzada, México-Xochimilco 101, Huipulco, Mexico City, CDMX 14370, Mexico
  • h Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Calzada, México-Xochimilco 101, Huipulco, Mexico City, CDMX 14370, Mexico
  • i Center of Excellence in Mental Health Research, CES University, Calle 10A No. 22-04, Medellín, 050021, Colombia
  • j Universidad Cayetano Heredia, Lima, Peru, and National Institute of Health, Capac Yapanqui 1400, Jesus María, Lima, Peru
  • k Center for Reducing Health Disparities, University of California, Davis School of Medicine, 2921 Stockton Boulevard, Sacramento, CA 95817, United States
  • l Anxiety Disorders Clinic and Research Center, Av. Santa Fe 3946-1A, Buenos Aires, CP1425, Argentina
  • m Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
  • n Department of Health Care Policy, Harvard University Medical School, 180A Longwood Avenue, Boston, MA 02115, United States
  • o Department of Health Care Policy, Harvard University Medical School, 180A Longwood Avenue, Boston, MA 02115, United States
  • p Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, United States, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, United States

Abstract

Purpose: Our understanding of community-level predictors of individual mental disorders in large urban areas of lower income countries is limited. In particular, the proportion of migrant, unemployed, and poorly educated residents in neighborhoods of these urban areas may characterize group contexts and shape residents’ health. Methods: Cross-sectional household interviews of 7251 adults were completed across 83 neighborhoods of Buenos Aires, Argentina; Medellín, Colombia; São Paulo, Brazil; Lima, Peru; and Mexico City, Mexico as part of the World Mental Health Survey Initiative. Past-year internalizing and externalizing mental disorders were assessed, and multilevel models were used. Results: Living in neighborhoods with either an above-average or below-average proportion of migrants and highly educated residents was associated with lower odds of any internalizing disorder (for proportion migrants: OR 0.75, 95% CI 0.62–0.91 for the bottom tertile and OR 0.79, 95% CI 0.67–0.94 for the top tertile compared to the middle tertile; for proportion highly educated: OR 0.76, 95% CI 0.64–0.90 for the bottom tertile and OR 0.58, 95% CI 0.37–0.90 for the top tertile compared to the middle tertile). Living in neighborhoods with an above-average proportion of unemployed individuals was associated with higher odds of having any internalizing disorder (OR 1.49, 95% CI 1.14–1.95 for the top tertile compared to the middle tertile). The proportion of highly educated residents was associated with lower odds of externalizing disorder (OR 0.54, 95% CI 0.31–0.93 for the top tertile compared to the middle tertile). Conclusions: The associations of neighborhood-level migration, unemployment, and education with individual-level odds of mental disorders highlight the importance of community context for understanding the burden of mental disorders among residents of rapidly urbanizing global settings. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

Author Keywords

Urban health Neighborhood effects Externalizing disorders Internalizing disorders Latin america

Index Keywords

urban population unemployment educational status South and Central America Argentina Latin America demography poverty human middle aged statistics and numerical data Colombia Health Surveys Urbanization Mexico Mental Disorders Residence Characteristics Cross-Sectional Studies mental disease cross-sectional study Humans psychology male female Socioeconomic Factors socioeconomics Cities city adult migration multilevel analysis Brazil Transients and Migrants Peru health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85053229963&doi=10.1007%2fs00127-018-1595-x&partnerID=40&md5=89a160202b8562753977090256ea8719
DOI: 10.1007/s00127-018-1595-x
ISSN: 09337954
Cited by: 2
Original Language: English