The relationship between neighborhood-level socioeconomic characteristics and individual mental disorders in five cities in Latin America: multilevel models from the World Mental Health Surveys

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 54; no. 2; pp. 157 - 170
• Main Authors: Sampson, Laura, Martins, Silvia S., Yu, Shui, Chiavegatto Filho, Alexandre Dias Porto, Andrade, Laura Helena, Viana, Maria Carmen, Medina-Mora, Maria Elena, Benjet, Corina, Torres, Yolanda, Piazza, Marina, Aguilar-Gaxiola, Sergio, Cia, Alfredo H., Stagnaro, Juan Carlos, Zaslavsky, Alan M., Kessler, Ronald C., Galea, Sandro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2019; Springer; Springer Nature B.V
• Subjects: Adult; Adults; Argentina - epidemiology; Brazil - epidemiology; Cities - epidemiology; Colombia - epidemiology; Communities; Cross-Sectional Studies; Education; Educational Status; Employment; Epidemiology; Female; Health Surveys; Humans; Latin America - epidemiology; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental health; Mental illness; Mentally ill; Mexico - epidemiology; Middle Aged; Migration; Multilevel Analysis; Neighborhoods; Original Paper; Peru - epidemiology; Poverty - psychology; Psychiatry; Residence Characteristics - statistics & numerical data; Socioeconomic Factors; Surveys; Transients and Migrants - psychology; Unemployment; Unemployment - psychology; Urban areas; Urban Population - statistics & numerical data; Urbanization; Colombia; Argentina; Brazil; Mexico; Cities; Peru; Latin America; Neighborhood effects; Externalizing disorders; Urban health; Internalizing disorders; Latin America
• ISSN: 0933-7954; 1433-9285; 1433-9285
• DOI: 10.1007/s00127-018-1595-x

Purpose Our understanding of community-level predictors of individual mental disorders in large urban areas of lower income countries is limited. In particular, the proportion of migrant, unemployed, and poorly educated residents in neighborhoods of these urban areas may characterize group contexts and shape residents’ health. Methods Cross-sectional household interviews of 7251 adults were completed across 83 neighborhoods of Buenos Aires, Argentina; Medellín, Colombia; São Paulo, Brazil; Lima, Peru; and Mexico City, Mexico as part of the World Mental Health Survey Initiative. Past-year internalizing and externalizing mental disorders were assessed, and multilevel models were used. Results Living in neighborhoods with either an above-average or below-average proportion of migrants and highly educated residents was associated with lower odds of any internalizing disorder (for proportion migrants: OR 0.75, 95% CI 0.62–0.91 for the bottom tertile and OR 0.79, 95% CI 0.67–0.94 for the top tertile compared to the middle tertile; for proportion highly educated: OR 0.76, 95% CI 0.64–0.90 for the bottom tertile and OR 0.58, 95% CI 0.37–0.90 for the top tertile compared to the middle tertile). Living in neighborhoods with an above-average proportion of unemployed individuals was associated with higher odds of having any internalizing disorder (OR 1.49, 95% CI 1.14–1.95 for the top tertile compared to the middle tertile). The proportion of highly educated residents was associated with lower odds of externalizing disorder (OR 0.54, 95% CI 0.31–0.93 for the top tertile compared to the middle tertile). Conclusions The associations of neighborhood-level migration, unemployment, and education with individual-level odds of mental disorders highlight the importance of community context for understanding the burden of mental disorders among residents of rapidly urbanizing global settings.