Proximity to healthcare clinic and depression risk in South Africa: geospatial evidence from a nationally representative longitudinal study |
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| Authors: | Andrew Tomita Alain M. Vandormael Diego Cuadros Rob Slotow Frank Tanser Jonathan K. Burns |
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| Affiliation: | 1.College of Health Sciences,University of KwaZulu-Natal,Durban,South Africa;2.Department of Geography,University of Cincinnati,Cincinnati,USA;3.School of Life Sciences,University of KwaZulu-Natal,Durban,South Africa;4.Department of Genetics, Evolution and Environment,University College London,London,UK;5.Africa Health Research Institute,University of KwaZulu-Natal,Durban,South Africa;6.Centre for the AIDS Programme of Research in South Africa (CAPRISA),Durban,South Africa;7.School of Nursing and Public Health,University of KwaZulu-Natal,Durban,South Africa;8.Department of Psychiatry,University of KwaZulu-Natal,Durban,South Africa;9.Institute for Health Research,University of Exeter,Exeter,UK |
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| Abstract: | Proximity to primary healthcare facilities may be a serious barrier to accessing mental health services in resource-limited settings. In this study, we examined whether the distance to the primary healthcare clinic (PHCC) was associated with risk of depression in KwaZulu-Natal Province, South Africa. Depressive symptoms and household coordinates data were accessed from the nationally representative South African National Income Dynamics Study. Distances between households and their nearest PHCCs were calculated and mixed-effects logistic regression models fitted to the data. Participants residing <6 km from a PHCC (aOR?=?0.608, 95% CI 0.42–0.87) or 6–14.9 km (aOR?=?0. 612, 95% CI 0.44–0.86) had a lower depression risk compared to those residing ≥15 km from the nearest PHCC. Distance to the PHCC was independently associated with increased depression risk, even after controlling for key socioeconomic determinants. Minimizing the distance to PHCC through mobile health clinics and technology could improve mental health. |
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