Neighborhood Deprivation and Mental Health Among Immigrants to Sweden.
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ABSTRACT:
SUBMITTER: Raphael E
PROVIDER: S-EPMC7138696 | biostudies-literature | 2020 May
REPOSITORIES: biostudies-literature
Publications
Neighborhood Deprivation and Mental Health Among Immigrants to Sweden.
Raphael Eva E White Justin S JS Li Xinjun X Cederin Klas K Glymour M Maria MM Sundquist Kristina K Sundquist Jan J Hamad Rita R
Epidemiology (Cambridge, Mass.) 20200501 3
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Project description:Background: No study to date, as far as we know, has analyzed the potential effect of neighborhood-level deprivation on autoimmune disorders (ADs), when adjusted for individual-level characteristics. Methods: A total of 5.4 million individuals from 8363 neighborhoods, comprising the whole Swedish population (ages 25-74 years), were followed for the period 1 January 2000, until admission due to diagnosis of ADs during the period of the study, or the conclusion of the study (31 December 2010). We used a neighborhood deprivation index, constructed from variables such as low education, low income, unemployment, and social welfare assistance, to assess the level of neighborhood deprivation. Multilevel logistic regression was used in the analysis with individual level characteristics at the first level and level of neighborhood deprivation at the second level. Results: A significant association between level of neighborhood deprivation and ADs was found. The crude odds were 1.32 (95% confidence interval 1.27-1.36) for those residing in the high-deprived neighborhoods compared to those living in low-deprivation neighborhoods. In the full model, where individual level characteristics were taken into account, the odds of ADs were 1.18 (1.14-1.22) in the most deprived neighborhoods. Certain Ads-angiitis hypersensitive (5.14), ankylosing spondylitis (1.66), celiac disease (1.65), Crohn's disease (1.21), diabetes mellitus type 1 (1.45), Graves's disease (1.13), Hashimoto thyroiditis (1.51), psoriasis (1.15), rheumatoid arthritis (1.15), sarcoidosis (1.20), and systemic sclerosis (1.27)-remained significantly associated with high level of neighborhood deprivation after adjustment for the individual-level variables. Conclusion: This study is the largest to date analyzing the potential influence of neighborhood deprivation on ADs. Our results indicate that neighborhood deprivation may affect risk of ADs, independent of individual level sociodemographic characteristics. For health care policies, both individual and neighborhood level approaches seem to be of importance.
| S-EPMC6843782 | biostudies-literature
Project description:•Maternal relative deprivation is linked to intrauterine growth restriction.•Neighborhood income inequality is linked to fewer low Apgar scores in high-income mothers.•Findings support relative deprivation hypothesis over income inequality hypothesis.
| S-EPMC11755026 | biostudies-literature
Project description:PurposeTo examine whether there is an association between neighborhood deprivation and age-related eye diseases, particularly macular degeneration, cataract, diabetes-related eye complications, and glaucoma.MethodsThe study population comprised a nationwide sample of 2,060,887 men and 2,250,851 women aged 40 years or older living in Sweden who were followed from 1 January 2000 until the first hospitalization/outpatient registration for age-related eye disease during the study period, death, emigration, or the end of the study period on 31 December 2010. Multilevel logistic regression was used to estimate the association between neighborhood deprivation and age-related eye diseases.ResultsIn men, the odds ratio (OR) for age-related eye diseases for those living in high-deprivation neighborhoods compared to those living in low-deprivation neighborhoods remained significant after adjustment for potential confounding factors (macular degeneration, OR 1.08, 95% confidence interval [CI] 1.03-1.12; cataract, OR 1.31, 95% CI 1.26-1.35; diabetes-related eye complications, OR 1.36, 95% CI 1.30-1.43; glaucoma, OR 1.11, 95% CI 1.06-1.15). In women, similar patterns were observed (macular degeneration, OR 1.11, 95% CI 1.07-1.15; cataract, OR 1.36, 95% CI 1.31-1.40; diabetes-related eye complications, OR 1.50, 95% CI 1.42-1.59; glaucoma, OR 1.12, 95% CI 1.08-1.17).ConclusionOur results suggest that neighborhood deprivation is associated with age-related eye diseases in both men and women. These results implicate that individual- as well as neighborhood-level factors are important for preventing age-related eye diseases.
| S-EPMC4767890 | biostudies-literature
Project description:Immigrants tend to live in areas with higher co-ethnic density, and the effect of neighborhood ethnic composition could be particularly salient for health. This study explored associations between neighborhood ethnic composition and self-rated health among Asian immigrants. We analyzed data collected at baseline from 670 Chinese and Vietnamese immigrants enrolled in a lifestyle intervention trial. Residential addresses were geocoded and combined with neighborhood socio-demographic profiles based on census data. We used generalized estimating equations to examine neighborhood ethnic composition and self-rated health. Independent of individual-level factors, living in neighborhoods more densely populated by whites was associated with poor/fair self-rated health. Neighborhood household income and density of participants' own ethnic group were not associated with poor/fair self-rated health. More research is warranted to disentangle reasons why Chinese and Vietnamese immigrants living in white-concentrated neighborhoods reported poorer self-rated health, including investigating effects of discrimination, relative deprivation, and availability of social resources.
| S-EPMC8208464 | biostudies-literature
Project description:Hygiene norms in Sweden are generally loose compared to most other countries. Does this looseness affect the hygiene norms among people who immigrate to Sweden from other countries? In a study of hygiene norms among immigrants to Sweden, the change in the physical environment and material living conditions, acculturation to Swedish culture and norms, and selection effects were all expected to lead immigrant hygiene norms to be closer to Swedish looseness. However, in a sample of 447 immigrants from 12 different countries, immigrants reported hygiene norms that were even stricter than those found in their countries of origin. We propose an explanation based on a combination of uncertainty about prevailing hygiene norms and the social risk and stigma associated with being perceived as unhygienic. We conclude that acculturation processes may rely on mechanisms that are domain specific.
| S-EPMC9939453 | biostudies-literature
Project description:BackgroundOur aim was to study the potential effect of neighborhood deprivation on incident heart failure (HF) in patients with diabetes mellitus (DM).MethodsThe study population included adults (n = 434,542) aged 30 years or older with DM followed from 2005 to 2015 in Sweden for incident HF. The association between neighborhood deprivation and the outcome was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for age, educational level, family income, employment status, region of residence, immigrant status, marital status, mobility, and comorbidities. DM patients living in neighborhoods with high or moderate levels of deprivation were compared with those living in neighborhoods with low deprivation scores (reference group).ResultsThere was an association between level of neighborhood deprivation and HF in DM patients. The HRs were 1.27, 95% CI 1.21-1.33, for men and 1.30, 95% CI 1.23-1.37, for women) among DM patients living in high deprivation neighborhoods compared with those from low deprivation neighborhoods. After adjustments for potential confounders, the higher HRs of HF remained significant: 1.11, 95% CI 1.06-1.16, in men and 1.15, 95% CI 1.09-1.21, in women living in high deprivation neighborhoods.ConclusionsIncreased incidence rates of HF among DM patients living in deprived neighborhoods raise important clinical and public health concerns. These findings could serve as an aid to policy-makers when allocating resources in primary health-care settings as well as to clinicians who encounter patients in deprived neighborhoods.
| S-EPMC6821579 | biostudies-literature
Project description:BackgroundWe sought to examine whether neighborhood deprivation is associated with participation in a large population-based health check. Such analyses will help answer the question whether health checks, which are designed to meet the needs of residents in deprived neighborhoods, may increase participation and prove to be more effective in preventing disease. In Europe, no study has previously looked at the association between neighborhood deprivation and participation in a population-based health check.MethodsThe study population comprised 12,768 persons invited for a health check including screening for ischemic heart disease and lifestyle counseling. The study population was randomly drawn from a population of 179,097 persons living in 73 neighborhoods in Denmark. Data on neighborhood deprivation (percentage with basic education, with low income and not in work) and individual socioeconomic position were retrieved from national administrative registers. Multilevel regression analyses with log links and binary distributions were conducted to obtain relative risks, intraclass correlation coefficients and proportional change in variance.ResultsLarge differences between neighborhoods existed in both deprivation levels and neighborhood health check participation rate (mean 53%; range 35-84%). In multilevel analyses adjusted for age and sex, higher levels of all three indicators of neighborhood deprivation and a deprivation score were associated with lower participation in a dose-response fashion. Persons living in the most deprived neighborhoods had up to 37% decreased probability of participating compared to those living in the least deprived neighborhoods. Inclusion of individual socioeconomic position in the model attenuated the neighborhood deprivation coefficients, but all except for income deprivation remained statistically significant.ConclusionNeighborhood deprivation was associated with participation in a population-based health check in a dose-response manner, in which increasing neighborhood deprivation was associated with decreasing participation. This suggests the need to develop preventive health checks tailored to deprived neighborhoods.
| S-EPMC4454539 | biostudies-literature
Project description:BackgroundIncarcerated individuals with mental illness face unique health challenges, yet we know little about individuals with mental illness who are detained by US immigration authorities. We aimed to describe the health-related experiences of detained immigrants with and without mental illness.MethodsWe conducted a cross-sectional telephone survey in 2021 with a sample of recently detained immigrants who were detained by Immigrations and Customs Enforcement (ICE) and released in the United States in 2020-2021 (n = 203). We used multivariable regression to assess the association between mental illness and the incidence of five outcomes while in immigration detention: 1) poor general health, 2) difficulty accessing medical services, 3) difficulty accessing mental health services, 4) interruptions to care, 5) and exposure to solitary confinement.Results115/203 participants (56.7 %) had diagnosed mental illness, most commonly depression and PTSD. Rates of poor health, difficulty accessing medical and mental health services, interruptions to care, and exposure to solitary confinement during detention were high overall, and significantly higher among individuals with mental illness.ConclusionThere is pressing need for policy actions and protections to mitigate health harms experienced in immigration detention.
| S-EPMC11773275 | biostudies-literature
Project description:BackgroundAccess to child and adolescent mental health services by ethnic minorities has been poorly studied. Despite rapid growth of the immigrant Korean population, evidence indicates that few Korean families utilise these services in New Zealand. Those that do tend to present late and with significant morbidity. We sought to understand barriers to service access from Korean parents' perspectives.MethodSeven focus groups were undertaken with 31 Korean parents of children aged 18 and under. The focus groups were semi-structured, held in the Korean language and utilised two case scenarios of common childhood/adolescent mental illnesses around which a set of broad, open-ended questions were posed. All conversations were audiorecorded, transcribed and translated into English. Thematic analysis was conducted using NVivo software.ResultsBoth attitudinal and structural barriers were identified. Attitudinal barriers included attribution of mental illness to external stressors or parenting problems, social stigma, denial or normalization of children's behaviour, fear of family disempowerment, and mistrust of public mental health services. Structural barriers included parents' lack of information regarding available services, logistical difficulties in access, communication difficulties, concerns over the quality of translators, and cultural competence of service providers.ConclusionSignificant barriers prevent Korean immigrant families from accessing child and adolescent mental health services in New Zealand. Measures to improve access, for example by countering stigma, are urgently required.
| S-EPMC8895579 | biostudies-literature
Project description:BackgroundIndividual measures of socioeconomic status (SES) have been associated with an increased risk of neural tube defects (NTDs); however, the association between neighborhood SES and NTD risk is unknown. Using data from the National Birth Defects Prevention Study (NBDPS) from 1997 to 2011, we investigated the association between measures of census tract SES and NTD risk.MethodsThe study population included 10,028 controls and 1829 NTD cases. We linked maternal addresses to census tract SES measures and used these measures to calculate the neighborhood deprivation index. We used generalized estimating equations to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) estimating the impact of quartiles of census tract deprivation on NTDs adjusting for maternal race-ethnicity, maternal education, and maternal age at delivery.ResultsQuartiles of higher neighborhood deprivation were associated with NTDs when compared with the least deprived quartile (Q2: aOR = 1.2; 95% CI = 1.0, 1.4; Q3: aOR = 1.3, 95% CI = 1.1, 1.5; Q4 (highest): aOR = 1.2; 95% CI = 1.0, 1.4). Results for spina bifida were similar; however, estimates for anencephaly and encephalocele were attenuated. Associations differed by maternal race-ethnicity.ConclusionsOur findings suggest that residing in a census tract with more socioeconomic deprivation is associated with an increased risk for NTDs, specifically spina bifida.
| S-EPMC10928547 | biostudies-literature