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Social Psychiatry and Psychiatric Epidemiology

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15.04.2019 | Original Paper

Development of the Australian neighborhood social fragmentation index and its association with spatial variation in depression across communities

verfasst von: Nasser Bagheri, Philip J. Batterham, Luis Salvador-Carulla, Yingxi Chen, Andrew Page, Alison L. Calear, Peter Congdon

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 10/2019

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Abstract

Purpose

We know little about how community structures influence the risk of common mental illnesses. This study presents a new way to establish links between depression and social fragmentation, thereby identifying pathways to better target mental health services and prevention programs to the right people in the right place.

Method

A principal components analysis (PCA) was conducted to develop the proposed Australian neighborhood social fragmentation index (ANSFI). General practice clinical data were used to identify cases of diagnosed depression. The association between ANSFI and depression was explored using multilevel logistic regression. Spatial hot spots (clusters) of depression prevalence and social fragmentation at the statistical area level 1 (SA1) were examined.

Results

Two components of social fragmentation emerged, reflecting fragmentation related to family structure and mobility. Individuals treated for depression in primary care were more likely to live in neighborhoods with lower socioeconomic status and with higher social fragmentation related to family structure. A 1-SD increase in social fragmentation was associated with a 16% higher depression prevalence (95% CI 11%, 20%). However, the association attenuated with adjustment for neighborhood socio-economic status. Considerable spatial variation in social fragmentation and depression patterns across communities was observed.

Conclusions

Developing a social fragmentation index for the first time in Australia at a small area level generates a new line of knowledge on the impact of community structures on health risks. Findings may extend our understanding of the mechanisms that drive geographical variation in the incidence of common mental disorders and mental health care.

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Titel: Development of the Australian neighborhood social fragmentation index and its association with spatial variation in depression across communities
verfasst von: Nasser Bagheri
Philip J. Batterham
Luis Salvador-Carulla
Yingxi Chen
Andrew Page
Alison L. Calear
Peter Congdon
Publikationsdatum: 15.04.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 10/2019
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-019-01712-y

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Development of the Australian neighborhood social fragmentation index and its association with spatial variation in depression across communities