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Residential segregation, dividing walls and mental health: a population-based record linkage study

BACKGROUND: Neighbourhood segregation has been described as a fundamental determinant of physical health, but literature on its effect on mental health is less clear. While most previous research has relied on conceptualised measures of segregation, Northern Ireland is unique as it contains physical...

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Detalles Bibliográficos
Autores principales: Maguire, Aideen, French, Declan, O'Reilly, Dermot
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013154/
https://www.ncbi.nlm.nih.gov/pubmed/26858342
http://dx.doi.org/10.1136/jech-2015-206888
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author Maguire, Aideen
French, Declan
O'Reilly, Dermot
author_facet Maguire, Aideen
French, Declan
O'Reilly, Dermot
author_sort Maguire, Aideen
collection PubMed
description BACKGROUND: Neighbourhood segregation has been described as a fundamental determinant of physical health, but literature on its effect on mental health is less clear. While most previous research has relied on conceptualised measures of segregation, Northern Ireland is unique as it contains physical manifestations of segregation in the form of segregation barriers (or ‘peacelines’) which can be used to accurately identify residential segregation. METHODS: We used population-wide health record data on over 1.3 million individuals, to analyse the effect of residential segregation, measured by both the formal Dissimilarity Index and by proximity to a segregation barrier, on the likelihood of poor mental health. RESULTS: Using multilevel logistic regression models, we found residential segregation measured by the Dissimilarity Index poses no additional risk to the likelihood of poor mental health after adjustment for area-level deprivation. However, residence in an area segregated by a ‘peaceline’ increases the likelihood of antidepressant medication by 19% (OR=1.19, 95% CI 1.14 to 1.23) and anxiolytic medication by 39% (OR=1.39, 95% CI 1.32 to 1.48), even after adjustment for gender, age, conurbation, deprivation and crime. CONCLUSIONS: Living in an area segregated by a ‘peaceline’ is detrimental to mental health suggesting segregated areas characterised by a heightened sense of ‘other’ pose a greater risk to mental health. The difference in results based on segregation measure highlights the importance of choice of measure when studying segregation.
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spelling pubmed-50131542016-09-12 Residential segregation, dividing walls and mental health: a population-based record linkage study Maguire, Aideen French, Declan O'Reilly, Dermot J Epidemiol Community Health Social Environment and Health BACKGROUND: Neighbourhood segregation has been described as a fundamental determinant of physical health, but literature on its effect on mental health is less clear. While most previous research has relied on conceptualised measures of segregation, Northern Ireland is unique as it contains physical manifestations of segregation in the form of segregation barriers (or ‘peacelines’) which can be used to accurately identify residential segregation. METHODS: We used population-wide health record data on over 1.3 million individuals, to analyse the effect of residential segregation, measured by both the formal Dissimilarity Index and by proximity to a segregation barrier, on the likelihood of poor mental health. RESULTS: Using multilevel logistic regression models, we found residential segregation measured by the Dissimilarity Index poses no additional risk to the likelihood of poor mental health after adjustment for area-level deprivation. However, residence in an area segregated by a ‘peaceline’ increases the likelihood of antidepressant medication by 19% (OR=1.19, 95% CI 1.14 to 1.23) and anxiolytic medication by 39% (OR=1.39, 95% CI 1.32 to 1.48), even after adjustment for gender, age, conurbation, deprivation and crime. CONCLUSIONS: Living in an area segregated by a ‘peaceline’ is detrimental to mental health suggesting segregated areas characterised by a heightened sense of ‘other’ pose a greater risk to mental health. The difference in results based on segregation measure highlights the importance of choice of measure when studying segregation. BMJ Publishing Group 2016-09 2016-02-08 /pmc/articles/PMC5013154/ /pubmed/26858342 http://dx.doi.org/10.1136/jech-2015-206888 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Social Environment and Health
Maguire, Aideen
French, Declan
O'Reilly, Dermot
Residential segregation, dividing walls and mental health: a population-based record linkage study
title Residential segregation, dividing walls and mental health: a population-based record linkage study
title_full Residential segregation, dividing walls and mental health: a population-based record linkage study
title_fullStr Residential segregation, dividing walls and mental health: a population-based record linkage study
title_full_unstemmed Residential segregation, dividing walls and mental health: a population-based record linkage study
title_short Residential segregation, dividing walls and mental health: a population-based record linkage study
title_sort residential segregation, dividing walls and mental health: a population-based record linkage study
topic Social Environment and Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013154/
https://www.ncbi.nlm.nih.gov/pubmed/26858342
http://dx.doi.org/10.1136/jech-2015-206888
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