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Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults

OBJECTIVES: Health disparities in schizophrenia are well established. However, it is less understood whether area-level socioeconomic status (SES) is differentially associated with schizophrenia depending on individual-level SES. Therefore, using a nationally large representative data, this study in...

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Autores principales: Luo, Yanan, Zhang, Lei, He, Ping, Pang, Lihua, Guo, Chao, Zheng, Xiaoying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6731895/
https://www.ncbi.nlm.nih.gov/pubmed/31488464
http://dx.doi.org/10.1136/bmjopen-2018-026532
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author Luo, Yanan
Zhang, Lei
He, Ping
Pang, Lihua
Guo, Chao
Zheng, Xiaoying
author_facet Luo, Yanan
Zhang, Lei
He, Ping
Pang, Lihua
Guo, Chao
Zheng, Xiaoying
author_sort Luo, Yanan
collection PubMed
description OBJECTIVES: Health disparities in schizophrenia are well established. However, it is less understood whether area-level socioeconomic status (SES) is differentially associated with schizophrenia depending on individual-level SES. Therefore, using a nationally large representative data, this study investigated the association between individual-level SES, area-level SES and their interaction with schizophrenia in Chinese adults from a multilevel perspective. SETTING: Household interviews in 734 counties (districts), 2980 towns (streets) and 5964 communities (villages) from 31 provinces, People's Republic of China, as part of the cross-sectional survey of Second China National Sample Survey on Disability. PARTICIPANTS: 1 909 205 men and women aged 18 years old and above. PRIMARY AND SECONDARY OUTCOME MEASURES: A screen followed by clinical diagnosis was used to identify schizophrenia, and schizophrenia was ascertained according to the International Statistical Classification of Diseases, 10th Revision (code F20). RESULTS: 1-SD increase in individual SES was associated with decreased risk of schizophrenia (OR=0.45, 95% CI 0.43 to 0.46). 1-SD increase in area-level SES was associated with increased risk of schizophrenia (OR=1.30, 95% CI 1.24 to 1.37). The interaction of individual SES and area-level SES was statistically significant (OR=1.05, 95% CI 1.02 to 1.08); as the level of area SES increased, schizophrenia risk of lower SES people grew faster than the risk of higher SES people. CONCLUSIONS: Area-level SES is particularly important to mental health of low SES individuals, with low SES people in high SES counties having the highest risk of schizophrenia than other groups. Action to reduce SES disparities in schizophrenia will require attention to the area-level context of low SES adults.
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spelling pubmed-67318952019-09-20 Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults Luo, Yanan Zhang, Lei He, Ping Pang, Lihua Guo, Chao Zheng, Xiaoying BMJ Open Mental Health OBJECTIVES: Health disparities in schizophrenia are well established. However, it is less understood whether area-level socioeconomic status (SES) is differentially associated with schizophrenia depending on individual-level SES. Therefore, using a nationally large representative data, this study investigated the association between individual-level SES, area-level SES and their interaction with schizophrenia in Chinese adults from a multilevel perspective. SETTING: Household interviews in 734 counties (districts), 2980 towns (streets) and 5964 communities (villages) from 31 provinces, People's Republic of China, as part of the cross-sectional survey of Second China National Sample Survey on Disability. PARTICIPANTS: 1 909 205 men and women aged 18 years old and above. PRIMARY AND SECONDARY OUTCOME MEASURES: A screen followed by clinical diagnosis was used to identify schizophrenia, and schizophrenia was ascertained according to the International Statistical Classification of Diseases, 10th Revision (code F20). RESULTS: 1-SD increase in individual SES was associated with decreased risk of schizophrenia (OR=0.45, 95% CI 0.43 to 0.46). 1-SD increase in area-level SES was associated with increased risk of schizophrenia (OR=1.30, 95% CI 1.24 to 1.37). The interaction of individual SES and area-level SES was statistically significant (OR=1.05, 95% CI 1.02 to 1.08); as the level of area SES increased, schizophrenia risk of lower SES people grew faster than the risk of higher SES people. CONCLUSIONS: Area-level SES is particularly important to mental health of low SES individuals, with low SES people in high SES counties having the highest risk of schizophrenia than other groups. Action to reduce SES disparities in schizophrenia will require attention to the area-level context of low SES adults. BMJ Publishing Group 2019-09-04 /pmc/articles/PMC6731895/ /pubmed/31488464 http://dx.doi.org/10.1136/bmjopen-2018-026532 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Mental Health
Luo, Yanan
Zhang, Lei
He, Ping
Pang, Lihua
Guo, Chao
Zheng, Xiaoying
Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults
title Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults
title_full Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults
title_fullStr Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults
title_full_unstemmed Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults
title_short Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults
title_sort individual-level and area-level socioeconomic status (ses) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million chinese adults
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6731895/
https://www.ncbi.nlm.nih.gov/pubmed/31488464
http://dx.doi.org/10.1136/bmjopen-2018-026532
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