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

Fone, David, White, James, Farewell, Daniel, Kelly, Megan, John, G., Lloyd, K., Williams, G. and Dunstan, Frank David John 2014. Effect of neighbourhood deprivation and social cohesion on mental health inequality: a multilevel population-based longitudinal study. Psychological Medicine 44 (11) , pp. 2449-2460. 10.1017/S0033291713003255

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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.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Healthcare Sciences
Medicine
Social Sciences (Includes Criminology and Education)
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
Uncontrolled Keywords: Epidemiology; longitudinal studies; mental health; social environment; social medicine
Publisher: Cambridge University Press
ISSN: 0033-2917
Last Modified: 19 Feb 2019 22:04
URI: http://orca-mwe.cf.ac.uk/id/eprint/75579

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