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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 |
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| Authors: | Sampson Laura Martins Silvia S. Yu Shui Chiavegatto Filho Alexandre Dias Porto Andrade Laura Helena Viana Maria Carmen Medina-Mora Maria Elena Benjet Corina Torres Yolanda Piazza Marina Aguilar-Gaxiola Sergio Cia Alfredo H. Stagnaro Juan Carlos Zaslavsky Alan M. Kessler Ronald C. Galea Sandro |
| Affiliation: | 1.Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA ;2.Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA ;3.Department of Epidemiology, School of Public Health of the University of São Paulo, 715 Av Dr Arnaldo, São Paulo, 01246-904, Brazil ;4.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 ;5.Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espirito Santo, Av. Mal. Campos, 1355, Vitória, Espirito Santo, 29043-260, Brazil ;6.Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente Muñiz, Calzada, México-Xochimilco 101, Huipulco, 14370, Mexico City, CDMX, Mexico ;7.Center of Excellence in Mental Health Research, CES University, Calle 10A No. 22-04, Medellín, 050021, Colombia ;8.Universidad Cayetano Heredia, Lima, Peru, and National Institute of Health, Capac Yapanqui 1400, Jesus María, Lima, Peru ;9.Center for Reducing Health Disparities, University of California, Davis School of Medicine, 2921 Stockton Boulevard, Sacramento, CA, 95817, USA ;10.Anxiety Disorders Clinic and Research Center, Av. Santa Fe 3946-1A, CP1425, Buenos Aires, Argentina ;11.Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina ;12.Department of Health Care Policy, Harvard University Medical School, 180A Longwood Avenue, Boston, MA, 02115, USA ; |
| 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. MethodsCross-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. ResultsLiving 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). ConclusionsThe 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. |
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