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Effect of neighbourhood deprivation and social cohesion on mental health inequality: a multilevel population-based longitudinal study

Published online by Cambridge University Press:  22 January 2014

D. Fone ,
J. White ,
D. Farewell ,
M. Kelly ,
G. John ,
K. Lloyd ,
G. Williams  and
F. Dunstan
D. Fone*
Affiliation:
Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, Wales, UK
J. White
Affiliation:
Centre for the Development and Evaluation of Complex Public Health Interventions, School of Medicine, Cardiff University, Cardiff, Wales, UK
D. Farewell
Affiliation:
Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, Wales, UK
M. Kelly
Affiliation:
Institute for Translation, Innovation, Methodology and Engagement, School of Medicine, Cardiff University, Cardiff, Wales, UK
G. John
Affiliation:
NHS Wales Informatics Service, Cardiff, Wales, UK
K. Lloyd
Affiliation:
College of Medicine, Swansea University, Swansea, Wales, UK
G. Williams
Affiliation:
School of Social Sciences, Cardiff University, Cardiff, Wales, UK
F. Dunstan
Affiliation:
Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, Wales, UK
*
*Address for correspondence: D. Fone, Professor of Health Sciences Research, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS, Wales, UK. (Email: [email protected])
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Abstract

Background

The common mental disorders (CMDs) of anxiety and depression are the most common form of poor mental health in the general population. Evidence from the small number of previous cohort studies on the role of neighbourhood factors in mental health is inconclusive. We tested the hypothesis that high levels of neighbourhood social cohesion modify an adverse association between change in individual mental health and neighbourhood deprivation.

Method

We carried out a longitudinal multilevel analysis using data from the Caerphilly Health and Social Needs Cohort Study with a 7-year follow-up (n = 4426; age range 18–74 years at baseline). Neighbourhood deprivation and neighbourhood social cohesion were assessed at baseline and change in mental health between follow-up and baseline was assessed using the five-item Mental Health Inventory (MHI-5).

Results

Residence in the most deprived neighbourhoods was negatively associated with change in mental health, after adjusting for baseline individual socio-economic risk factors and transitions in life events. This negative effect was significantly reduced in high social cohesion neighbourhoods. The predicted change in mental health score was calculated for the 10th and 90th centiles of the household low-income distribution. The difference between them was −2.8 in the low social cohesion group and 1.1 in the high cohesion group. The difference between the groups was 3.9 [95% confidence interval (CI) 0.2–7.6].

Conclusions

The public health burden of poor mental health and mental health inequality could potentially be reduced by strengthening social cohesion in deprived neighbourhoods. This offers a mechanism to address the adverse effect of neighbourhood deprivation on population mental health.

Keywords

Epidemiologylongitudinal studiesmental healthsocial environmentsocial medicine
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 11 , August 2014 , pp. 2449 - 2460
Copyright
Copyright © Cambridge University Press 2014 

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References

Almedom, A (2005). Social capital and mental health: an interdisciplinary review of primary evidence. Social Science and Medicine 61, 943–964.CrossRefGoogle ScholarPubMed
Berwick, DM, Murphy, JM, Goldman, PA, Ware, JE Jr, Barsky, AJ, Weinstein, MC (1991). Performance of a five-item mental health screening test. Medical Care 29, 169–176.CrossRefGoogle ScholarPubMed
Blakely, TA, Woodward, AJ (2000). Ecological effects in multi-level studies. Journal of Epidemiology and Community Health 54, 367–374.CrossRefGoogle ScholarPubMed
Buckner, JC (1988). The development of an instrument to measure neighbourhood cohesion. American Journal of Community Psychology 16, 771–791.CrossRefGoogle Scholar
Cattell, V (2001). Poor people, poor places, and poor health: the mediating role of social cohesions and social capital. Social Science and Medicine 52, 1501–1516.CrossRefGoogle Scholar
Connolly, S, O'Reilly, D, Rosato, M (2007). Increasing inequalities in health: is it an artefact caused by the selective movement of people? Social Science and Medicine 64, 2008–2015.CrossRefGoogle ScholarPubMed
Crockett, A, Afkhami, R, Rafferty, A, Higgins, V, Marshall, A (2011). Weighting the Social Surveys. ESDS Government. UK Data Archive and Institute for Social and Economic Research.Google Scholar
Croft-Jefferys, C, Wilkinson, G (1989). Estimated costs of neurotic disorder in UK general practice. Psychological Medicine 19, 549–558.CrossRefGoogle Scholar
Cuijpers, P, Smits, N, Donker, T, ten Have, M, de Graaf, R (2009). Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory. Psychiatry Research 168, 250–255.CrossRefGoogle ScholarPubMed
De Silva, MJ, McKenzie, K, Harpham, T, Huttly, SRA (2005). Social capital and mental illness: a systematic review. Journal of Epidemiology and Community Health 59, 619–627.CrossRefGoogle ScholarPubMed
Dewa, CS, Thompson, AH, Jacobs, P (2011). The association of treatment of depressive episodes and work productivity. Canadian Journal of Psychiatry 56, 743–750.CrossRefGoogle ScholarPubMed
DWP (2012). Households Below Average Income (HBAI): An Analysis of the Income Distribution 1994/95 – 2009/10. National Statistics. Department for Work and Pensions: London (www.gov.uk/government/publications/households-below-average-income-hbai-199495-to-200910). Accessed 2 December 2013.Google Scholar
Fine, B (2001). Social Capital Versus Social Theory. Political Economy and Social Science at the Turn of the Millennium, pp. 189–190. Routledge: London.Google Scholar
Fone, DL, Dunstan, FD, Christie, S, Jones, A, West, J, Webber, M, Lester, N, Watkins, J (2006 a). Council tax valuation bands, socio-economic status and health outcome: a cross-sectional analysis from the Caerphilly Health and Social Needs Study. BMC Public Health 6, 115.CrossRefGoogle ScholarPubMed
Fone, DL, Dunstan, FD, John, A, Lloyd, K (2007 a). Associations between the common mental disorders and the Mental Illness Needs Index in community settings: a multilevel analysis. British Journal of Psychiatry 191, 158–163.CrossRefGoogle ScholarPubMed
Fone, DL, Dunstan, FD, Lloyd, K, Williams, GH, Watkins, J, Palmer, SR (2007 b). Does social cohesion modify the association between area income deprivation and mental health? A multilevel analysis. International Journal of Epidemiology 36, 338–345.CrossRefGoogle ScholarPubMed
Fone, DL, Dunstan, FD, White, J, Kelly, M, Farewell, D, John, G, Lyons, RA, Lloyd, K (2012). Cohort profile: the Caerphilly Health and Social Needs Electronic Cohort Study (E-CATALYsT). International Journal of Epidemiology. Published online: 5 November 2012 . doi: 10.1093/ije/dys175.Google ScholarPubMed
Fone, DL, Farewell, DM, Dunstan, FD (2006 b). An ecometric analysis of neighbourhood cohesion. Population Health Metrics 4, 17.CrossRefGoogle ScholarPubMed
Ford, E, Clark, C, McManus, S, Harris, J, Jenkins, R, Bebbington, P, Brugha, T, Meltzer, H, Stansfeld, SA (2010). Common mental disorders, unemployment and welfare benefits in England. Public Health 124, 675–681.CrossRefGoogle ScholarPubMed
Fryers, T, Melzer, D, Jenkins, R (2003). Social inequalities and the common mental disorders. Social Psychiatry and Psychiatric Epidemiology 38, 229–237.CrossRefGoogle ScholarPubMed
Harpham, T, Grant, E, Thomas, E (2002). Measuring social capital within health surveys: key issues. Health Policy and Planning 17, 106–111.CrossRefGoogle ScholarPubMed
Hemingway, H, Stafford, M, Stansfeld, S, Shipley, M, Marmot, M (1997). Is the SF-36 a valid measure of change in population health? Results from the Whitehall II study. British Medical Journal 15, 1273–1279.CrossRefGoogle Scholar
Kawachi, I, Berkman, LF (2000). Social cohesion, social capital, and health. In Social Epidemiology (ed. Berkman, L. F. and Kawachi, I.), Ch. 8, pp. 174–190. Oxford University Press: New York.CrossRefGoogle Scholar
Kawachi, I, Kennedy, BP, Glass, R (1999). Social capital and self-rated health: a contextual analysis. American Journal of Public Health 89, 1187–1193.CrossRefGoogle Scholar
Kelly, M, Dunstan, F, Lloyd, K, Fone, D (2008). Evaluating cutpoints for the MHI-5 and MCS using the GHQ-12: a comparison of five different methods. BMC Psychiatry 8, 10.CrossRefGoogle ScholarPubMed
LaPierre, TA (2012). The enduring effects of marital status on subsequent depressive symptoms among women: investigating the roles of psychological, social and financial resources. Journal of Epidemiology and Community Health 66, 1056–1062.CrossRefGoogle ScholarPubMed
Lloyd, KR, Jenkins, R, Mann, A (1996). Long term outcome of patients with neurotic illness in general practice. British Medical Journal 313, 26–28.CrossRefGoogle ScholarPubMed
Macintyre, S, Ellaway, A, Cummins, S (2002). Place effects on health: how can we conceptualise, operationalise and measure them? Social Science and Medicine 55, 125–139.CrossRefGoogle Scholar
Macintyre, S, McKay, L, Der, G, Hiscock, R (2003). Socio-economic position and health: what you observe depends on how you measure it. Journal of Public Health Medicine 25, 288–294.CrossRefGoogle Scholar
Mair, C, Diez Roux, AV, Galea, S (2008). Are neighbourhood characteristics associated with depressive symptoms? A review of evidence. Journal of Epidemiology and Community Health 62, 940–946.Google ScholarPubMed
Mair, C, Diez Roux, AV, Shen, M, Shea, S, Seeman, T, Echeverria, S, O'Meara, ES (2009). Cross-sectional and longitudinal associations of neighborhood cohesion and stressors with depressive symptoms in the multiethnic study of atherosclerosis. Annals of Epidemiology 19, 49–57.CrossRefGoogle ScholarPubMed
McCabe, CJ, Thomas, KJ, Brazier, JE, Coleman, P (1996). Measuring the mental health status of a population: a comparison of the GHQ-12 and the SF-36 (MHI-5). British Journal of Psychiatry 169, 517–521.CrossRefGoogle ScholarPubMed
McKenzie, K, Whitley, R, Weich, S (2002). Social capital and mental health. British Journal of Psychiatry 181, 280–283.CrossRefGoogle ScholarPubMed
McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R (2009). Adult Psychiatric Morbidity in England, 2007. Results of a Household Survey. The NHS Information Centre for Health and Social Care: London.Google Scholar
Merlo, J (2003). Multilevel analytical approaches in social epidemiology: measures of health variation compared with traditional measures of association. Journal of Epidemiology and Community Health 57, 550–552.CrossRefGoogle ScholarPubMed
Muntaner, C, Lynch, J, Davy Smith, G (2000). Social capital and the third way in public health. Critical Public Health 10, 107–124.CrossRefGoogle Scholar
Murayama, H, Fujiwara, Y, Kawachi, I (2012). Social capital and health: a review of prospective multilevel studies. Journal of Epidemiology 22, 179–187.CrossRefGoogle Scholar
Norman, P, Boyle, P, Rees, P (2005). Selective migration, health and deprivation: a longitudinal analysis. Social Science and Medicine 60, 2755–2771.CrossRefGoogle ScholarPubMed
Pevalin, DJ, Goldberg, DP (2003). Social precursors to onset and recovery from episodes of common mental illness. Psychological Medicine 33, 299–306.CrossRefGoogle ScholarPubMed
Propper, C, Jones, K, Bolster, A, Burgess, S, Johnston, R, Sarker, R (2005). Local neighbourhood and mental health: evidence from the UK. Social Science and Medicine 61, 2065–2083.CrossRefGoogle ScholarPubMed
Putnam, RD (1993). Making Democracy Work: Civic Traditions in Modern Italy. Princeton University Press: Princeton, NJ.Google Scholar
Rai, D, Kosidou, K, Lundberg, M, Araya, R, Lewis, G, Magnusson, C (2012). Psychological distress and risk of long-term disability: population-based longitudinal study. Journal of Epidemiology and Community Health 66, 586–592.CrossRefGoogle ScholarPubMed
Rasbash, J, Steele, F, Browne, W, Goldstein, H (2009). A User's Guide to MlwiN version 2.10. Centre for Multilevel Modelling: University of Bristol.Google Scholar
Rumpf, H-J, Meyer, C, Hapke, U, John, U (2001). Screening for mental health: validity of the MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Research 105, 243–253.CrossRefGoogle ScholarPubMed
Russ, TC, Stamatakis, E, Hamer, M, Starr, JM, Kivimäki, M, Batty, GD (2012). Association between psychological distress and mortality: individual participant pooled analysis of 10 prospective cohort studies. British Medical Journal 345, e4933.CrossRefGoogle ScholarPubMed
Sacker, A, Wiggins, RD (2002). Age-period-cohort effects on inequalities in psychological distress, 1981-2000. Psychological Medicine 32, 977–990.CrossRefGoogle ScholarPubMed
Sampson, RJ, Morenoff, JD, Gannon-Rowley, T (2002). Assessing ‘neighbourhood effects’: social processes and new directions in research. Annual Review of Sociology 28, 443–478.CrossRefGoogle Scholar
Singer, JD, Willett, JB (2003). A framework for investigating change over time. In Applied Longitudinal Data Analysis. Modelling Change and Event Occurrence, pp. 9–10. Oxford University Press: New York.CrossRefGoogle Scholar
Skapinakis, P (2007). Commentary: Socioeconomic position and common mental disorders: what do we need to know? International Journal of Epidemiology 36, 786–788.CrossRefGoogle ScholarPubMed
Stafford, M, Bartley, M, Sacker, A, Marmot, M (2003). Measuring the social environment: social cohesion and material deprivation in English and Scottish neighbourhoods. Environment and Planning A 35, 1459–1475.CrossRefGoogle Scholar
Stafford, M, De Silva, M, Stansfeld, S, Marmot, M (2008 a). Neighbourhood social capital and common mental disorder: testing the link in a general population sample. Health and Place 14, 394–405.CrossRefGoogle Scholar
Stafford, M, Duke-Williams, O, Shelton, N (2008 b). Small area inequalities in health: are we underestimating them? Social Science and Medicine 67, 891–899.CrossRefGoogle Scholar
Stafford, M, Gimeno, D, Marmot, MG (2008 c). Neighbourhood characteristics and trajectories of health functioning: a multilevel prospective analysis. European Journal of Public Health 18, 604–610.CrossRefGoogle ScholarPubMed
Subramanian, SV, Kim, DJ, Kawachi, I (2002). Social trust and self-rated health in US communities: a multilevel analysis. Journal of Urban Health 79, 521–534.CrossRefGoogle ScholarPubMed
Subramanian, SV, Lochner, KA, Kawachi, I (2003). Neighborhood differences in social capital: a compositional artifact or a contextual construct? Health and Place 9, 33–44.CrossRefGoogle ScholarPubMed
Thomas, C, Benzeval, M, Stansfeld, SA (2005). Employment transitions and mental health: an analysis from the British household panel survey. Journal of Epidemiology and Community Health 59, 243–249.CrossRefGoogle ScholarPubMed
Thomas, C, Benzeval, M, Stansfeld, S (2007). Psychological distress after employment transitions: the role of subjective financial position as a mediator. Journal of Epidemiology and Community Health 61, 48–52.CrossRefGoogle ScholarPubMed
Wade, TJ, Pevalin, DJ (2004). Marital transitions and mental health. Journal of Health and Social Behaviour 45, 155–170.CrossRefGoogle ScholarPubMed
Ware, JE Jr., Gandek, B (1998). Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. Journal of Clinical Epidemiology 51, 903–912.CrossRefGoogle ScholarPubMed
Ware, JE Jr., Kosinski, M, Dewey, JE (2000). How to Score Version 2 of the SF-36® Health Survey. QualityMetric Incorporated: Lincoln, RI.Google Scholar
Ware, JE Jr., Kosinski, M, Gandek, B (1993). SF-36® Health Survey: Manual and Interpretation Guide. QualityMetric Incorporated: Lincoln, RI.Google Scholar
Weich, S (1997). Prevention of the common mental disorders: a public health perspective. Psychological Medicine 27, 757–764.CrossRefGoogle ScholarPubMed
Weich, S, Twigg, L, Lewis, G, Jones, K (2005). Geographical variation in rates of common mental disorders in Britain: prospective cohort study. British Journal of Psychiatry 187, 29–34.CrossRefGoogle ScholarPubMed
White, IR, Royston, P, Wood, AM (2010). Multiple imputation using chained equations: issues and guidance for practice. Statistics in Medicine 30, 377–399.CrossRefGoogle ScholarPubMed
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