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Original Article
- Contextual and Individual Determinants of Mental Health: A Cross-sectional Multilevel Study in Tehran, Iran
- Homeira Sajjadi, Gholamreza Ghaedamini Harouni, Hassan Rafiey, Mohammadreza Vaez-Mahdavi, Meroe Vameghi, Seyed Hossein Mohaqeqi Kamal
- J Prev Med Public Health. 2020;53(3):189-197. Published online April 14, 2020
- DOI: https://doi.org/10.3961/jpmph.19.150
- 5,566 View
- 163 Download
- 6 Crossref
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Abstract
PDF - Objectives
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?
Methods
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.
Results
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.
Conclusions
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. -
Summary
Citations
Citations to this article as recorded by
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BMC Medical Research Methodology.2022;[Epub] CrossRef
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