Background
Methods
Study population
Current episode of major depressive disorder
Neighborhood income and individual equalized income
Chronic diseases and life style factors
Acute and long-term stress
Social participation
Other control variables
Statistical analysis
Neighborhood income | |||||
---|---|---|---|---|---|
All residential areas | Less than 1400 €/month | 1400-1599 €/month | 1600-1799 €/month | 1800 €/month or more | |
N | 71058 | 9315 | 29970 | 18400 | 13373 |
% Current major depressive episode | 2.5 | 3.3 | 2.8 | 2.3 | 1.6 |
Individual equivalized income | |||||
Mean, sd | 1514 (568) | 1388 (556) | 1455 (554) | 1555 (570) | 1673 (565) |
% Missing | 15.1 | 16.3 | 15.9 | 14.3 | 13.7 |
Demographic characteristics | |||||
Age (mean, sd) | 43.7 (11.6) | 42.1 (11.9) | 43.3 (11.6) | 44.1 (11.5) | 45.4 (11.3) |
% Female | 58.0 | 59.0 | 58.1 | 57.8 | 57.3 |
% Married | 61.6 | 53.9 | 61.5 | 62.4 | 66.2 |
Highest education | |||||
% Elementary | 2.2 | 3.1 | 2.6 | 1.6 | 1.5 |
% Lower secondary | 26.1 | 30.3 | 29.3 | 23.5 | 19.4 |
% Upper secondary | 39.7 | 40.7 | 41.1 | 40.0 | 35.4 |
% Tertiary | 29.9 | 23.8 | 24.9 | 32.7 | 41.4 |
% Missing | 2.2 | 2.2 | 2.2 | 2.2 | 2.3 |
Diseases | |||||
% No disease | 77.0 | 75.4 | 76.0 | 77.9 | 79.0 |
% One disease | 9.5 | 9.8 | 9.9 | 8.9 | 9.2 |
% Two or more diseases | 13.5 | 14.9 | 14.1 | 13.2 | 11.8 |
Body mass index | |||||
% < =18.5 kg/m2 | 0.8 | 0.8 | 0.8 | 0.8 | 0.7 |
% 18.5 - 24.9 kg/m2 | 45.0 | 44.6 | 42.8 | 45.6 | 49.1 |
% 25–29.9 kg/m2 | 38.8 | 36.9 | 39.2 | 39.4 | 38.3 |
% 30.0 - 34.9 kg/m2 | 11.5 | 12.6 | 12.6 | 10.7 | 9.5 |
% > =35 kg/m2 | 3.9 | 5.0 | 4.5 | 3.5 | 2.5 |
Physical activity (at least 30. min) | |||||
% Physically inactive | 4.3 | 5.3 | 4.7 | 3.9 | 3.4 |
% One day per week | 8.2 | 8.4 | 8.8 | 8.2 | 7.0 |
% Two days per week | 11.2 | 11.5 | 11.4 | 11.4 | 10.5 |
% Three or more days per week | 70.3 | 67.9 | 68.6 | 71.4 | 74.4 |
Smoking | |||||
% Never smoking | 43.3 | 42.3 | 41.4 | 45.1 | 45.8 |
% Formerly smoking | 28.8 | 26.8 | 28.2 | 29.2 | 31.0 |
% Currently smoking | 22.3 | 26.1 | 24.0 | 20.8 | 18.0 |
% Missing | 5.6 | 4.8 | 6.4 | 4.9 | 5.2 |
Alcohol consumptiona | |||||
% Abstaining | 21.2 | 23.2 | 23.5 | 19.5 | 17.0 |
% Moderately drinking | 61.4 | 60.4 | 58.5 | 63.7 | 65.3 |
% Heavily drinking | 14.4 | 14.2 | 14.7 | 14.0 | 14.6 |
% Missing | 3.0 | 2.2 | 3.2 | 2.9 | 3.1 |
Stress | |||||
No. of threatening events in past year (LTE), 0–12 (mean, sd) | 1.1 (1.3) | 1.2 (1.4) | 1.1 (1.3) | 1.0 (1.3) | 1.0 (1.2) |
% Missing | 2.6 | 3.2 | 2.7 | 2.2 | 2.3 |
Score on long-term difficulty inventory (LDI), 0–24 (mean, sd) | 2.4 (2.4) | 2.7 (2.5) | 2.4 (2.4) | 2.4 (2.3) | 2.3 (2.3) |
% Missing | 3.3 | 4.1 | 3.3 | 2.9 | 3.1 |
Social participation | |||||
No. of personal contacts in past two weeks (mean, sd) | 18.2 (14.5) | 17.8 (14.6) | 18.1 (14.5) | 18.3 (14.4) | 18.8 (14.6) |
No. of participations in clubs or groups, 0–6 (mean, sd) | 0.9 (0.9) | 0.9 (0.9) | 0.9 (0.9) | 1.0 (0.9) | 0.9 (0.9) |
Score on social need fulfillment scale (SPF-IL), 0–27 (mean, sd) | 16.0 (3.5) | 15.7 (3.6) | 15.9 (3.6) | 16.0 (3.4) | 16.3 (3.4) |
% Missing | 3.7 | 4.4 | 3.9 | 3.4 | 3.2 |
Results
Neighborhood income | |||||
---|---|---|---|---|---|
All residential areas | Less than 1400 €/month | 1400-1599 €/month | 1600-1799 €/month | 1800 €/month or more | |
N | 1893 | 289 | 552 | 484 | 568 |
Demographic characteristics | |||||
Neighborhoods in strongly urbanized area (N, %)a | 456 (24.1) | 74 (25.6) | 104 (18.8) | 93 (19.2) | 185 (32.6) |
Non-western migrants (%, sd) | 5.5 (8.7) | 9.6 (14.6) | 4.8 (7.9) | 4.3 (6.5) | 5.1 (6.1) |
Single occupied households (%, sd) | 31.2 (15.2) | 33.8 (17.5) | 31.3 (13.8) | 29.9 (13.7) | 30.9 (16.2) |
Population older than 65 years (%, sd) | 15.1 (8.0) | 13.4 (6.2) | 15.1 (7.3) | 15.1 (7.6) | 15.8 (9.5) |
Socioeconomic characteristics | |||||
Owner occupied houses (%, sd) | 64.9 (20.6) | 55.6 (26.4) | 62.7 (19.2) | 67.3 (16.8) | 69.8 (19.5) |
Households receiving assistance benefits (%, sd) | 3.8 (3.5) | 7.0 (5.6) | 4.3 (3.2) | 2.9 (2.0) | 2.2 (1.9) |
Households living below social minimum (%, sd)b | 8.1 (5.1) | 12.9 (6.6) | 8.7 (4.5) | 7.1 (3.8) | 6.1 (3.8) |
Evaluation of conceptual model of absolute poverty | Evaluation of conceptual models of relative poverty and collective resources | |||||
---|---|---|---|---|---|---|
Univariate logistic regression modelse | Regression model 1 | Regression model 2 | Regression model 3 | Regression model 4 | Regression model 5 | |
(OR with 95 % CI) | (OR with 95 % CI) | (OR with 95 % CI) | (OR with 95 % CI) | (OR with 95 % CI) | (OR with 95 % CI) | |
Neighborhood and household income | ||||||
Neighborhood incomea | 0.64 (0.57;0.73) | 0.82 (0.73;0.93) | 0.89 (0.79;1.00) | 0.87 (0.77;0.98) | 0.90 (0.79;1.01) | 0.69 (0.52;0.92) |
Individual equalized incomea | 0.62 (0.59;0.65) | 0.72 (0.68;0.76) | 0.75 (0.71;0.80) | 0.89 (0.83;0.95) | 0.92 (0.87;0.98) | 0.59 (0.43;0.80) |
Neighborhood income*individual equalized income | 1.06 (0.96;1.18)d | 1.07 (0.97;1.17) | ||||
Demographic characteristics | ||||||
Age | 0.99 (0.99;1.00) | 1.00 (1.00;1.00) | 1.00 (0.99;1.00) | 1.01 (1.01;1.02) | 1.01 (1.00;1.01) | 1.00 (1.00;1.00) |
Female | 1.62 (1.46;1.79) | 1.46 (1.32;1.62) | 1.38 (1.23;1.54) | 1.24 (1.10;1.39) | 1.27 (1.13;1.42) | 1.46 (1.31;1.62) |
Married | 0.53 (0.48;0.59) | 0.55 (0.49;0.61) | 0.58 (0.52;0.65) | 0.79 (0.71;0.88) | 0.80 (0.72;0.90) | 0.55 (0.49;0.61) |
Highest education | ||||||
Tertiary | Ref. | Ref. | Ref. | Ref. | Ref. | |
Upper secondary | 1.80 (1.55;2.08) | 1.42 (1.21;1.65) | 1.28 (1.09;1.50) | 1.50 (1.28;1.76) | 1.37 (1.17;1.61) | 1.42 (1.22;1.66) |
Lower secondary | 3.07 (2.65;3.55) | 2.44 (2.07;2.87) | 1.96 (1.66;2.32) | 2.58 (2.17;3.06) | 2.10 (1.76;2.50) | 2.45 (2.07;2.88) |
Elementary | 5.98 (4.76;7.51) | 4.03 (3.15;5.16) | 3.02 (2.35;3.90) | 3.99 (3.05;5.22) | 2.97 (2.26;3.90) | 4.05 (3.16;5.18) |
Diseases | ||||||
No disease | Ref. | Ref. | Ref. | |||
One disease | 1.88 (1.63;2.16) | 1.61 (1.39;1.86) | 1.43 (1.23;1.66) | 1.43 (1.22;1.66) | ||
Two or more diseases | 2.23 (1.99;2.51) | 1.84 (1.63;2.07) | 1.42 (1.26;1.61) | 1.36 (1.20;1.55) | ||
Body mass index | ||||||
<=18.5 kg/m2 | 1.98 (1.32;2.99) | 1.36 (0.89;2.06) | 1.39 (0.89;2.15) | 1.31 (0.84;2.04) | ||
18.5–24.9 kg/m2 | Ref. | Ref. | Ref. | Ref. | ||
25–29.9 kg/m2 | 0.92 (0.82;1.03) | 0.95 (0.85;1.07) | 0.91 (0.80;1.02) | 0.92 (0.82;1.04) | ||
30.0–34.9 kg/m2 | 1.52 (1.32;1.75) | 1.30 (1.12;1.50) | 1.21 (1.04;1.41) | 1.20 (1.03;1.40) | ||
> = 35 kg/m2 | 2.82 (2.37;3.34) | 1.89 (1.58;2.25) | 1.57 (1.30;1.90) | 1.51 (1.25;1.84) | ||
Physical activity (at least 30. minutes) | ||||||
Three or more days per week | Ref. | Ref. | Ref. | |||
Two days per week | 1.06 (0.90;1.24) | 1.01 (0.85;1.21) | 1.03 (0.86;1.24) | 1.00 (0.84;1.21) | ||
One day per week | 1.48 (1.27;1.74) | 1.26 (1.07;1.47) | 1.26 (1.06;1.49) | 1.16 (0.97;1.38) | ||
Physically inactive | 2.22 (1.86;2.65) | 1.57 (1.28;1.92) | 1.58 (1.28;1.95) | 1.42 (1.15;1.75) | ||
Smoking | ||||||
Never smoking | Ref. | Ref. | Ref. | |||
Formerly smoking | 1.01 (0.89;1.14) | 1.07 (0.93;1.22) | 0.99 (0.87;1.14) | 1.00 (0.87;1.14) | ||
Currently smoking | 2.12 (1.89;2.39) | 1.76 (1.55;2.00) | 1.45 (1.27;1.65) | 1.46 (1.28;1.67) | ||
Alcohol consumptionb | ||||||
Abstaining | 2.11 (1.89;2.35) | 1.65 (1.47;1.84) | 1.70 (1.51;1.91) | 1.52 (1.34;1.71) | ||
Moderately drinking | Ref. | Ref. | Ref. | Ref. | ||
Heavily drinking | 1.21 (1.04;1.40) | 1.17 (1.00;1.36) | 1.22 (1.04;1.43) | 1.19 (1.01;1.40) | ||
Stress | ||||||
No. of threatening events in past year (LTE) | 1.54 (1.50;1.57) | 1.18 (1.15;1.22) | 1.19 (1.16;1.23) | |||
Score on long-term difficulty inventory (LDI) | 1.38 (1.36;1.40) | 1.32 (1.30;1.34) | 1.27 (1.24;1.29) | |||
Social participation | ||||||
No. of personal contacts in past two weeks | 0.64 (0.60;0.69) | 0.85 (0.79;0.91) | ||||
No. of personal contacts in past two weeks squared c | 1.04 (1.03;1.04) | 1.02 (1.01;1.02) | ||||
No. of participations in clubs or groups | 0.65 (0.61;0.69) | 0.87 (0.86;0.89) | ||||
Score on social need fulfillment scale (SPF-IL) | 0.80 (0.79;0.81) | 0.83 (0.77;0.88) | ||||
sd random intercept neighborhood | 0.32 (0.24;0.41) | 0.28 (0.21;0.38) | 0.27 (0.19;0.38) | 0.24 (0.16;0.37) | 0.31 (0.24;0.41) |
Sensitivity analysis
Evaluation of conceptual model of absolute poverty | Evaluation of conceptual models of relative poverty and collective resources | ||||
---|---|---|---|---|---|
Regression model 1 | Regression model 2 | Regression model 3 | Regression model 4 | Regression model 5 | |
(OR with 95 % CI) | (OR with 95 % CI) | (OR with 95 % CI) | (OR with 95 % CI) | (OR with 95 % CI) | |
Alternative indicator of neighborhood poverty (N = 70982) | |||||
Percentage low income households in neighborhood (Z-standardized) | 1.16 (1.09;1.23) | 1.12 (1.06;1.19) | 1.09 (1.03;1.15) | 1.08 (1.02;1.14) | 1.24 (1.09;1.42) |
Individual equalized income | 0.72 (0.68;0.77) | 0.75 (0.70;0.79) | 0.88 (0.83;0.94) | 0.91 (0.86;0.97) | 0.78 (0.67”0.92) |
Percentage low income households in neighborhood*individual equalized income | 0.98 (0.93;1.02) | ||||
sd random intercept neighborhood | 0.30 (0.23;0.40) | 0.25 (0.17;0.36) | 0.23 (0.14;0.36) | 0.23 (0.14;0.37) | 0.30 (0.23;0.39) |
Complete cases (N = 50288) | |||||
Neighborhood income | 0.82 (0.71;0.94) | 0.89 (0.78;1.02) | 0.90 (0.79;1.04) | 0.93 (0.81;1.06) | 0.65 (0.46;0.91) |
Individual equalized income | 0.75 (0.71;0.80) | 0.77 (0.73;0.82) | 0.92 (0.86;0.98) | 0.95 (0.89;1.02) | 0.58 (0.40;0.82) |
Neighborhood income*individual equalized income | 1.09 (0.97;1.21) | ||||
sd random intercept neighborhood | 0.29 (0.21;0.39) | 0.24 (0.16;0.39) | 0.22 (0.13;0.37) | 0.21 (0.12’0.38) | 0.28 (0.21;0.39) |
Individuals older than 30 years (N = 61463) | |||||
Neighborhood income | 0.84 (0.74;0.96) | 0.90 (0.79;1.02) | 0.89 (0.79;1.01) | 0.91 (0.80;1.03) | 0.74 (0.53;1.04) |
Individual equalized income | 0.70 (0.65;0.76) | 0.73 (0.68;0.78) | 0.87 (0.81;0.94) | 0.91 (0.85;0.98) | 0.61 (0.42;0.87) |
Neighborhood income*individual equalized income | 1.05 (0.94;1.17) | ||||
sd random intercept neighborhood | 0.07 (0.03;0.18) | 0.02 (0.00;0.27) | 0.02 (0.00;0.40) | 0.02 (0.00;0.49) | 0.07 (0.03;0.18) |
Median odds ratio (MOR) | 1.28 | 1.15 | 1.15 | 1.14 | 1.28 |