Contextual and Individual Determinants of Mental Health: A Cross-sectional Multilevel Study in Tehran, Iran
Open Access
- 31 May 2020
- journal article
- Published by Korean Society for Preventive Medicine in Journal of Preventive Medicine & Public Health
- Vol. 53 (3), 189-197
- https://doi.org/10.3961/jpmph.19.150
Abstract
Our aim was to answer the following questions: (1) Can mental health variance be partitioned to individual and higher levels (e.g., neighborhood and district); (2) How much (as a percentage) do individual-level determinants explain the variability of mental health at the individual-level; and (3) How much do determinants at the neighborhood- or district-level explain the variability of mental health at the neighborhood- or district-level? We used raw data from the second round of the Urban Health Equity Assessment and Response Tool in Tehran (in 2012-2013, n=34 700 samples nested in 368 neighborhoods nested in 22 districts) and the results of the official report of Tehran's Center of Studies and Planning (in 2012-2013, n=22 districts). Multilevel linear regression models were used to answer the study questions. Approximately 40% of Tehran residents provided responses suggestive of having mental health disorders (30-52%). According to estimates of residual variance, 7% of mental health variance was determined to be at the neighborhood-level and 93% at the individual-level. Approximately 21% of mental health variance at the individual-level and 49% of the remaining mental health variance at the neighborhood-level were determined by determinants at the individual-level and neighborhood-level, respectively. If we want to make the most effective decisions about the determinants of mental health, in addition to considering the therapeutic perspective, we should have a systemic or contextual view of the determinants of mental health.Keywords
This publication has 27 references indexed in Scilit:
- Socioeconomic Inequalities in Adolescent Depression in South Korea: A Multilevel AnalysisPLOS ONE, 2012
- Mechanisms Linking Social Ties and Support to Physical and Mental HealthJournal of Health and Social Behavior, 2011
- Social Capital and Mental Health in Japan: A Multilevel AnalysisPLOS ONE, 2010
- Chronic Widespread Pain, Mental Health, and Physical Role Function in OEF/OIF VeteransPain Medicine, 2009
- Mental health, places and people: A multilevel analysis of economic inactivity and social deprivationHealth & Place, 2006
- Effects of neighbourhood socioeconomic status and convenience store concentration on individual level smokingJournal of Epidemiology and Community Health, 2005
- Self-esteem in a broad-spectrum approach for mental health promotionHealth Education Research, 2004
- Human Culture, Ecological Change, and Infectious Disease:Ecosystem Health, 2001
- Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical reviewJournal of Epidemiology and Community Health, 2001
- Neighbourhood differences in diet: the Atherosclerosis Risk in Communities (ARIC) StudyJournal of Epidemiology and Community Health, 1999