Improving mental health through neighbourhood regeneration: the role of cohesion, belonging, quality and disorder.
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SUBMITTER: Greene G
PROVIDER: S-EPMC7536250 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Improving mental health through neighbourhood regeneration: the role of cohesion, belonging, quality and disorder.
Greene Giles G Fone David D Farewell Daniel D Rodgers Sarah S Paranjothy Shantini S Carter Bethan B White James J
European journal of public health 20201001 5
Poor mental health has been associated with socioeconomic deprivation. The aim was to describe possible mechanisms underpinning the narrowing of mental health inequalities demonstrated by Communities First, an area-wide regeneration programme in Wales, UK. Propensity score matched data from the Caerphilly Health and Social Needs Electronic Cohort Study, assessed changes in mental health, neighbourhood-level social cohesion, belongingness, quality and disorder. A multiple mediation analysis found ...[more]
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Project description:Neighborhood-level interventions provide an opportunity to better understand the impact of neighborhoods on health. In 2001, the Welsh Government, United Kingdom, funded Communities First, a program of neighborhood regeneration delivered to the 100 most deprived of the 881 electoral wards in Wales. In this study, we examined the association between neighborhood regeneration and mental health. Information on regeneration activities in 35 intervention areas (n = 4,197 subjects) and 75 control areas (n = 6,695 subjects) was linked to data on mental health from a cohort study with assessments made in 2001 (before regeneration) and 2008 (after regeneration). Propensity score matching was used to estimate the change in mental health in intervention neighborhoods versus control neighborhoods. Baseline differences between intervention and control areas were of similar magnitude as produced by paired randomization of neighborhoods. Regeneration was associated with an improvement in the mental health of residents in intervention areas compared with control neighborhoods (? = 1.54, 95% confidence interval: 0.50, 2.59), suggesting a reduction in socioeconomic inequalities in mental health. There was a dose-response relationship between length of residence in regeneration neighborhoods and improvements in mental health (P-trend = 0.05). These results show that targeted regeneration of deprived neighborhoods can improve mental health.
| S-EPMC5860549 | biostudies-literature
Project description:BackgroundExposure to stressful life events is an established risk factor for the development of adolescent mental disorder. Growing evidence also suggests that neighbourhood social environments, including strong social cohesion, could have a protective effect on mental health. However, little is known about how neighbourhood social cohesion may buffer against the effects of stressful life events on adolescent mental health. Our aim was to assess whether neighbourhood social cohesion modifies the association between stressful life events and adolescent mental health outcomes.MethodsData were drawn from a nationally-representative prospective sample of Canadian adolescents, including 5183 adolescents aged 12/13 years at T1 and 14/15 years at T2. Caregivers reported neighbourhood social cohesion at T1, and exposure to stressful life events between T1 and T2. Symptoms of mental health and behaviour problems were self-reported by adolescents at T1 and T2. Multivariable logistic regression was used to determine whether the relationship between stressful life events and outcomes was modified by neighbourhood social cohesion.ResultsAssociations between stressful life events and adolescent outcomes were statistically significantly lower in neighbourhoods with greater social cohesion for: depression/anxiety (high cohesion OR = 0.98 v. low cohesion OR = 3.11), suicidal ideation (ORhigh = 1.30 v. ORlow = 5.25), aggression/conduct disorder (ORhigh = 1.09 v. ORlow = 4.27), and property offence (ORhigh = 1.21 v. ORlow = 4.21).ConclusionsGreater neighbourhood social cohesion appeared to buffer the effects of stressful life events on several domains of adolescent mental health. This potentially presents a target for public health intervention to improve adolescent mental health and behavioural outcomes.
| S-EPMC7322549 | biostudies-literature
Project description:AIMS: To assess the effectiveness of a parenting programme, delivered by health visitors in primary care, in improving the mental health of children and their parents among a representative general practice population. METHODS: Parents of children aged 2-8 years who scored in the upper 50% on a behaviour inventory were randomised to the Webster-Stratton 10 week parenting programme delivered by trained health visitors, or no intervention. Main outcome measures were the Eyberg Child Behaviour Inventory and the Goodman Strengths and Difficulties Questionnaire to measure child behaviour, and the General Health Questionnaire, Abidin's Parenting Stress Index, and Rosenberg's Self Esteem Scale to measure parents' mental health. These outcomes were measured before and immediately after the intervention, and at six months follow up. RESULTS: The intervention was more effective at improving some aspects of the children's mental health, notably conduct problems, than the no intervention control condition. The Goodman conduct problem score was reduced at immediate and six month follow up, and the Eyberg Child Behaviour Inventory was reduced at six months. The intervention also had a short term impact on social dysfunction among parents. These benefits were seen among families with children scoring in the clinical range for behaviour problems and also among children scoring in the non-clinical (normal) range. CONCLUSION: This intervention could make a useful contribution to the prevention of child behaviour problems and to mental health promotion in primary care.
| S-EPMC1755810 | biostudies-other
Project description:ObjectivesTo evaluate the psychometric properties of the Hong Kong version of Neighbourhood Cohesion Instrument (HK-NCI) and examine whether neighbourhood social cohesion as measured using HK-NCI would be associated with evaluative, hedonic and eudaemonic well-being.DesignA validation analysis followed by a cross-sectional analysis of a community-based survey.SettingCommunities in two districts (Sha Tin and Tai Po) in Hong Kong.Participants301 community-dwelling Chinese men and women aged 60 years and older normally residing in Sha Tin or Tai Po for not less than six consecutive months at the time of participation in the study were interviewed.MeasurementsNeighbourhood social cohesion was measured using the 15-item HK-NCI. The Social Cohesion Scale (SCS) and the Brief Sense of Community Scale (BSCS) were administered for assessing the validity of the HK-NCI. Evaluative (life satisfaction), hedonic (feelings of happiness) and eudaemonic well-being (sense of purpose and meaning in life) were examined. Socio-demographic characteristics, lifestyle and health behaviours, medical history, and neighbourhood characteristics were used as covariates.ResultsFor homogeneity, internal consistency of HK-NCI (?=0.813) was good. For stability (test-retest reliability), the averages of mean scores of the 15 items suggested an acceptable repeatability with an intra-class correlation coefficient=0.701(95% CI 0.497 to 0.832). HK-NCI was correlated with SCS (r=0.515-0.635, p<0.001) and BSCS (r=0.500-0.612, p<0.001). Neighbourhood social cohesion was positively and independently associated with life satisfaction, feelings of happiness and sense of purpose and meaning in life (all p values <0.05). Stratified analyses indicated that neighbourhood social cohesion was more strongly associated with all dimensions of subjective well-being in 'young-old' subgroup, and with sense of purpose and meaning in life for women.ConclusionThe HK-NCI has adequate levels of internal consistency and test-retest reliability. In addition, higher levels of neighbourhood social cohesion were associated with better subjective well-being among older Chinese people.
| S-EPMC6530414 | biostudies-literature
Project description:The main strategy for alleviating heart disease has been to target individuals and encourage them to change their health behaviours. Although important, emphasis on individuals has diverted focus and responsibility away from neighbourhood characteristics, which also strongly influence people's behaviours. Although a growing body of research has repeatedly demonstrated strong associations between neighbourhood characteristics and cardiovascular health, it has typically focused on negative neighbourhood characteristics. Only a few studies have examined the potential health enhancing effects of positive neighbourhood characteristics, such as perceived neighbourhood social cohesion.Using multiple logistic regression models, we tested whether higher perceived neighbourhood social cohesion was associated with lower incidence of myocardial infarction. Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults over the age of 50--were used to analyse 5276 participants with no history of heart disease. Respondents were tracked for 4?years and analyses adjusted for relevant sociodemographic, behavioural, biological and psychosocial factors.In a model that adjusted for age, gender, race, marital status, education and total wealth, each SD increase in perceived neighbourhood social cohesion was associated with a 22% reduced odds of myocardial infarction (OR=0.78, 95% CI 0.63 to 0.94. The association between perceived neighbourhood social cohesion and myocardial infarction remained even after adjusting for behavioural, biological and psychosocial covariates.Higher perceived neighbourhood social cohesion may have a protective effect against myocardial infarction.
| S-EPMC4600604 | biostudies-literature
Project description:BACKGROUND:Prior investigations have found negative associations between military unit cohesion and posttraumatic stress disorder (PTSD); however, most relied on cross-sectional data and few examined relationships of unit cohesion to other mental disorders. This study evaluates prospective associations of perceived unit cohesion with a range of mental health outcomes following combat deployment. METHODS:U.S. Army soldiers were surveyed approximately 1-2 months before deployment to Afghanistan (T0); and 1 month (T1), 3 months (T2), and 9 months (T3) after return from deployment. Logistic regression was performed to estimate associations of perceived unit cohesion at T0 with risk of PTSD, major depressive episode (MDE), generalized anxiety disorder (GAD), alcohol or substance use disorder (AUD/SUD), and suicidal ideation at T2 or T3 among soldiers who completed all study assessments (N = 4,645). Models were adjusted for sociodemographic and Army service characteristics, predeployment history of the index outcome, and deployment stress exposure. RESULTS:Higher perceived unit cohesion at T0 was associated with lower risk of PTSD, MDE, GAD, AUD/SUD, and suicidal ideation at T2 or T3 (AORs = 0.72 to 0.85 per standard score increase in unit cohesion; P-values < 0.05). Models of incidence of mental disorders and suicidal ideation among soldiers without these problems predeployment yielded similar results, except that perceived unit cohesion was not associated with incident AUD/SUD. CONCLUSIONS:Soldiers who reported strong unit cohesion before deployment had lower risk of postdeployment mental disorders and suicidal ideation. Awareness of associations of perceived unit cohesion with postdeployment mental health may facilitate targeting of prevention programs.
| S-EPMC7058190 | biostudies-literature
Project description:The extent to which sleep is causally related to mental health is unclear. One way to test the causal link is to evaluate the extent to which interventions that improve sleep quality also improve mental health. We conducted a meta-analysis of randomised controlled trials that reported the effects of an intervention that improved sleep on composite mental health, as well as on seven specific mental health difficulties. 65 trials comprising 72 interventions and N = 8608 participants were included. Improving sleep led to a significant medium-sized effect on composite mental health (g+ = -0.53), depression (g+ = -0.63), anxiety (g+ = -0.51), and rumination (g+ = -0.49), as well as significant small-to-medium sized effects on stress (g+ = -0.42), and finally small significant effects on positive psychosis symptoms (g+ = -0.26). We also found a dose response relationship, in that greater improvements in sleep quality led to greater improvements in mental health. Our findings suggest that sleep is causally related to the experience of mental health difficulties. Future research might consider how interventions that improve sleep could be incorporated into mental health services, as well as the mechanisms of action that explain how sleep exerts an effect on mental health.
| S-EPMC8651630 | biostudies-literature
Project description:BackgroundThe assessment of 'general health and well-being' in public mental health research stimulates debates around relative merits of questionnaire instruments and their items. Little evidence regarding alignment or differential advantages of instruments or items has appeared to date.AimsPopulation-based psychometric study of items employed in public mental health narratives.MethodMultidimensional item response theory was applied to General Health Questionnaire (GHQ-12), Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and EQ-5D items (Health Survey for England, 2010-2012; n = 19 290).ResultsA bifactor model provided the best account of the data and showed that the GHQ-12 and WEMWBS items assess mainly the same construct. Only one item of the EQ-5D showed relevant overlap with this dimension (anxiety/depression). Findings were corroborated by comparisons with alternative models and cross-validation analyses.ConclusionsThe consequences of this lack of differentiation (GHQ-12 v. WEMWBS) for mental health and well-being narratives deserves discussion to enrich debates on priorities in public mental health and its assessment.
| S-EPMC4967770 | biostudies-literature
Project description:During their life course, older persons' income level may become discrepant with the socio-economic status of their neighbourhood. This study examines whether and how such discrepancies affect older persons' physical and mental health. Using baseline data from the Longitudinal Aging Study Amsterdam, 2,540 non-institutionalised persons aged 55-85 years were classified based on self-reported income and neighbourhood status. Two categories defined discrepancies: discrepant-low (DL, low income in high-status neighbourhood), and discrepant-high (DH, high income in low-status neighbourhood). Both categories were compared with the same reference category: matched-high (MH, high personal and high neighbourhood income status). A range of health indicators were examined, as well as mediating effects of neighbourhood and individual characteristics. Among the 504 persons who reported a high income, 16% lived in a low-status neighbourhood (DH). Conversely, among the 757 persons living in a high-status neighbourhood, 24% had a low income (DL). The DL category mainly lived in rural areas, and the DH category predominantly in large cities. The data show discrepant income effects (DL vs. MH) on physical and cognitive ability, self-rated health, and loneliness, and discrepant neighbourhood effects (DH vs. MH) on physical and cognitive ability, depressive symptoms, and loneliness. Personal income effects were partly mediated by other personal characteristics, and neighbourhood effects were fully mediated by socio-economic neighbourhood characteristics as well as by older persons' perceptions of their neighbourhood and their income. It is concluded that discrepancies between personal income and neighbourhood status, accrued throughout the life course, are associated with poor health.
| S-EPMC5547679 | biostudies-other
Project description:ObjectivesThe rapid growth of urban areas in China in the past few decades has introduced profound changes in family structure and income distribution that could plausibly affect mental health. Although multilevel studies of the influence of area-level socioeconomic factors on mental health have become more common in other parts of the world, a study of this sort has not been carried out in Chinese cities. Our objectives were to examine the associations of two key neighbourhood-level variables-median income and percentage of married individuals living in the neighbourhood-with mental disorders net of individual-level income and marital status in three Chinese cities.SettingHousehold interviews in Beijing, Shanghai and Shenzhen, PRC, as part of the cross-sectional World Mental Health Surveys.Participants4072 men and women aged 18-88 years.Primary and secondary outcome measuresLifetime and past-year internalising and externalising mental disorders.ResultsEach one-point increase in neighbourhood-level percentage of married residents was associated with a 1% lower odds of lifetime (p=0.024) and 2% lower odds of past-year (p=0.008) individual-level externalising disorder, net of individual-level marital status. When split into tertiles, individuals living in neighbourhoods in the top tertile of percentage of married residents had 54% lower odds of a past-year externalising disorder (OR=0.46, 95%?CI: 0.24 to 0.87) compared with those in the bottom tertile. Neighbourhood-level marital status was not statistically associated with either lifetime or past-year internalising disorders. Neighbourhood-level income was not statistically associated with odds of either internalising or externalising disorders.ConclusionsThe proportion of married residents in respondents' neighbourhoods was significantly inversely associated with having externalising mental disorders in this sample of Chinese cities. Possible mechanisms for this finding are discussed and related to social causation, social selection and social control theories. Future work should examine these relationships longitudinally.
| S-EPMC5652513 | biostudies-literature