Neighbourhood characteristics and mental disorders in three Chinese cities: multilevel models from the World Mental Health Surveys

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Porto Chiavegatto Filho, Alexandre Dias ^[1] ; Sampson, Laura ^[2] ; Martins, Silvia S. ^[3] ; Yu, Shui ^[2] ; Huang, Yueqin ^[4] ; He, Yanling ^[5] ; Lee, Sing ^[6] ; Hu, Chiyi ^{[7, 8]} ; Zaslavsky, Alan ^[9] ; Kessler, Ronald C. ^[9] ; Galea, Sandro ^{[2, 3]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Publ Hlth, Dept Epidemiol, Sao Paulo - Brazil

^[2] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02215 - USA

^[3] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY 10025 - USA

^[4] Peking Univ, Hosp 6, Inst Mental Hlth, Beijing - Peoples R China

^[5] Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Dept Psychiat Epidemiol & Psychiat, Shanghai - Peoples R China

^[6] Chinese Univ Hong Kong, Dept Psychiat, Hong Kong, Hong Kong - Peoples R China

^[7] Shenzhen Inst Mental Hlth, Shenzhen - Peoples R China

^[8] Shenzhen Kangning Hosp, Shenzhen - Peoples R China

^[9] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA - USA

• Tipo de documento: Artigo Científico
• Fonte: BMJ OPEN; v. 7, n. 10 OCT 2017.
• Citações Web of Science: 1

Resumo

Objectives The rapid growth of urban areas in China in the past few decades has introduced profound changes in family structure and income distribution that could plausibly affect mental health. Although multilevel studies of the influence of area-level socioeconomic factors on mental health have become more common in other parts of the world, a study of this sort has not been carried out in Chinese cities. Our objectives were to examine the associations of two key neighbourhood-level variables-median income and percentage of married individuals living in the neighbourhood-with mental disorders net of individual-level income and marital status in three Chinese cities. Setting Household interviews in Beijing, Shanghai and Shenzhen, PRC, as part of the cross-sectional World Mental Health Surveys. Participants 4072 men and women aged 18-88 years. Primary and secondary outcome measures Lifetime and past-year internalising and externalising mental disorders. Results Each one-point increase in neighbourhood-level percentage of married residents was associated with a 1% lower odds of lifetime (p=0.024) and 2% lower odds of past-year (p=0.008) individual-level externalising disorder, net of individual-level marital status. When split into tertiles, individuals living in neighbourhoods in the top tertile of percentage of married residents had 54% lower odds of a past-year externalising disorder (OR=0.46, 95% CI: 0.24 to 0.87) compared with those in the bottom tertile. Neighbourhood-level marital status was not statistically associated with either lifetime or past-year internalising disorders. Neighbourhood-level income was not statistically associated with odds of either internalising or externalising disorders. Conclusions The proportion of married residents in respondents' neighbourhoods was significantly inversely associated with having externalising mental disorders in this sample of Chinese cities. Possible mechanisms for this finding are discussed and related to social causation, social selection and social control theories. Future work should examine these relationships longitudinally. (AU)

• Processo FAPESP: 14/05363-7 - Cidades e saúde mental: determinantes sociais dos distúrbios mentais em grandes centros urbanos em uma análise multicêntrica do World Mental Health Survey Initiative
• Beneficiário: Alexandre Dias Porto Chiavegatto Filho
• Modalidade de apoio: Auxílio à Pesquisa - Regular