Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population

<b><i>Background:</i></b> Little is known about the extent to which socioenvironmental characteristics may influence mental health outcomes in smaller population centres or differently among women and men. This study used a gender-based analysis approach to explore individual...

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Autores principales:	Neeru Gupta, Dan Lawson Crouse, Ismael Foroughi, Thalia Nikolaidou
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	socioenvironmental determinants of health mental health services research gender and health population health surveillance residence characteristics spatial epidemiology Medicine R
Acceso en línea:	https://doaj.org/article/1239ea8405844417b50b9d7c49f1b30a
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spelling	oai:doaj.org-article:1239ea8405844417b50b9d7c49f1b30a2021-11-11T16:20:54ZGendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population10.3390/ijerph1821111971660-46011661-7827https://doaj.org/article/1239ea8405844417b50b9d7c49f1b30a2021-10-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11197https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601<b><i>Background:</i></b> Little is known about the extent to which socioenvironmental characteristics may influence mental health outcomes in smaller population centres or differently among women and men. This study used a gender-based analysis approach to explore individual- and neighbourhood-level sex differences in mental health service use in a context of uniquely smaller urban and rural settlements. <b><i>Methods:</i></b> This cross-sectional analysis leveraged multiple person-based administrative health datasets linked with geospatial datasets among the population aged 1 and over in the province of New Brunswick, Canada. We used multinomial logistic regression to examine associations between neighbourhood characteristics with risk of service contacts for mood and anxiety disorders in 2015/2016, characterizing the areal measures among all residents (gender neutral) and by males and females separately (gender specific), and controlling for age group. <b><i>Results:</i></b> Among the province’s 707,575 eligible residents, 10.7% (females: 14.0%; males: 7.3%) used mental health services in the year of observation. In models adjusted for gender-neutral neighbourhood characteristics, service contacts were significantly more likely among persons residing in the most materially deprived areas compared with the least (OR = 1.09 [95% CI: 1.05–1.12]); when stratified by individuals’ sex, the risk pattern held for females (OR = 1.13 [95% CI: 1.09–1.17]) but not males (OR = 1.00 [95% CI: 0.96–1.05]). Residence in the most female-specific materially deprived neighbourhoods was independently associated with higher risk of mental health service use among individual females (OR = 1.08 [95% CI: 1.02–1.14]) but not among males (OR = 1.02 [95% CI: 0.95–1.10]). <b><i>Conclusion:</i></b> These findings emphasize that research needs to better integrate sex and gender in contextual measures aiming to inform community interventions and neighbourhood designs, notably in small urban and rural settings, to reduce socioeconomic inequalities in the burden of mental disorders.Neeru GuptaDan Lawson CrouseIsmael ForoughiThalia NikolaidouMDPI AGarticlesocioenvironmental determinants of healthmental health services researchgender and healthpopulation health surveillanceresidence characteristicsspatial epidemiologyMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11197, p 11197 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	socioenvironmental determinants of health mental health services research gender and health population health surveillance residence characteristics spatial epidemiology Medicine R
spellingShingle	socioenvironmental determinants of health mental health services research gender and health population health surveillance residence characteristics spatial epidemiology Medicine R Neeru Gupta Dan Lawson Crouse Ismael Foroughi Thalia Nikolaidou Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population
description	<b><i>Background:</i></b> Little is known about the extent to which socioenvironmental characteristics may influence mental health outcomes in smaller population centres or differently among women and men. This study used a gender-based analysis approach to explore individual- and neighbourhood-level sex differences in mental health service use in a context of uniquely smaller urban and rural settlements. <b><i>Methods:</i></b> This cross-sectional analysis leveraged multiple person-based administrative health datasets linked with geospatial datasets among the population aged 1 and over in the province of New Brunswick, Canada. We used multinomial logistic regression to examine associations between neighbourhood characteristics with risk of service contacts for mood and anxiety disorders in 2015/2016, characterizing the areal measures among all residents (gender neutral) and by males and females separately (gender specific), and controlling for age group. <b><i>Results:</i></b> Among the province’s 707,575 eligible residents, 10.7% (females: 14.0%; males: 7.3%) used mental health services in the year of observation. In models adjusted for gender-neutral neighbourhood characteristics, service contacts were significantly more likely among persons residing in the most materially deprived areas compared with the least (OR = 1.09 [95% CI: 1.05–1.12]); when stratified by individuals’ sex, the risk pattern held for females (OR = 1.13 [95% CI: 1.09–1.17]) but not males (OR = 1.00 [95% CI: 0.96–1.05]). Residence in the most female-specific materially deprived neighbourhoods was independently associated with higher risk of mental health service use among individual females (OR = 1.08 [95% CI: 1.02–1.14]) but not among males (OR = 1.02 [95% CI: 0.95–1.10]). <b><i>Conclusion:</i></b> These findings emphasize that research needs to better integrate sex and gender in contextual measures aiming to inform community interventions and neighbourhood designs, notably in small urban and rural settings, to reduce socioeconomic inequalities in the burden of mental disorders.
format	article
author	Neeru Gupta Dan Lawson Crouse Ismael Foroughi Thalia Nikolaidou
author_facet	Neeru Gupta Dan Lawson Crouse Ismael Foroughi Thalia Nikolaidou
author_sort	Neeru Gupta
title	Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population
title_short	Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population
title_full	Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population
title_fullStr	Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population
title_full_unstemmed	Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population
title_sort	gendering neighbourhood marginalization metrics in mental health services research: a cross-sectional exploration of a rural and small urban population
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1239ea8405844417b50b9d7c49f1b30a
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Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population

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