Titre :
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Does social cohesion modify the association between area income deprivation and mental health ? A multilevel analysis. Commentary : Social Epidemiology. (2007)
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Auteurs :
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David FONE ;
Frank DUNSTAN ;
Keith Lloyd ;
Stephen PALMER ;
John WATKINS ;
Gareth Williams ;
ZUBRICK (Stephen-R) / disc. : AUS. Curtin University of Technology and the Telethon Institute for Child Health Research. West Perth Western Australia. ;
Cardiff University. School of Medicine. Centre for Health Sciences Research. Department of Epidemiology Statistics & Public Health. Cardiff. GBR ;
National Public Health Service for Wales. Mamhilad Park Estate. Pontypool Gwent. GBR
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Type de document :
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Article
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Dans :
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International journal of epidemiology (vol. 36, n° 2, 2007)
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Pagination :
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338-347
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Langues:
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Anglais
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Mots-clés :
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Psychopathologie
;
Milieu social
;
Epidémiologie
;
Facteur socioéconomique
;
Royaume Uni
;
Homme
;
Europe
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Résumé :
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[BDSP. Notice produite par INIST-CNRS R0xdBg3M. Diffusion soumise à autorisation]. Background : Despite the increasing belief that the places where people live influence their health, there is surprisingly little consistent evidence for their associations with mental health. We investigated the joint effect of community and individual-level socio-economic deprivation and social cohesion on individual mental health status. Methods : Multilevel analysis of population survey data on 10 653 adults aged 18-74 years nested within the 325 census enumeration districts in Caerphilly county borough, Wales, UK. The outcome measure was the Mental Health Inventory (MHI-5) subscale of the SF-36 instrument. A social cohesion subscale was derived from a factor analysis of responses to the Neighbourhood Cohesion scale and was modelled at individual and area level. Area income deprivation was measured by the percentage of low income households. Results : Poor mental health was significantly associated with area-level income deprivation and low social cohesion after adjusting for individual risk factors. High social cohesion significantly modified the association between income deprivation and mental health : the difference between the predicted mean area mental health scores at the 10th and 90th centiles of the low income distribution was 3.7 in the low cohesion group and 0.9 in the high cohesion group (difference of the difference in means=2.8,95% CI : 0.2,5.4). Conclusions : Income deprivation and social cohesion measured at community level are potentially important joint determinants of mental health. Further research on the impact of the social environment on mental health should investigate causal pathways in a longitudinal study.
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