Abstract
Relevant demographic and environmental conditions need to be understood before tailoring policies to improve mental health. Using community health survey data from 25 communities in Seoul, 2013, cross-sectional associations between mental health and community level environments were assessed. Mental health outcomes (self-rated stress levels (SRS) and depressive symptoms (DS)) were analyzed. Community environmental factors included green space, green facilities, and annual PM10 level (AnnPM10); socio-demographic factors included sex, age, education, labor market participation, comorbidity, sleep hours, physical activity, smoking, and drinking. A total of 23,139 people with the following characteristics participated: men (44.2%); age groups 19−39 (36.0%), 40−59 (39.4%), 60−74 (19.2%), and 75+ (5.4%). Women had higher odds ratios (OR) for SRS [OR 1.22, 95% Confidence interval (CI) 1.17–1.27] and DS [OR 1.55, 95% CI 1.42–1.71]. Regular physical activity predicted SRS [OR 0.90, 95% CI 0.84–0.95] and DS [OR 0.98, 95% CI 0.88–1.10]; current smoking and drinking were adversely associated with both SRS and DS. Higher accessibility to green space (Q4) was inversely associated with DS [OR 0.89, 95% CI 0.81−0.97] compared to lower accessibility (Q1). AnnPM10, annual levels for particles of aerodynamic diameter <10 µm (PM10), among communities was associated with poorer SRS [OR 1.02, 95% CI 1.00–1.04] by 10 μg/m3 increases. Therefore, both demographic and environmental factors should be considered to understand mental health conditions among the general population.
Highlights
annual PM10 level (AnnPM10), annual levels for particles of aerodynamic diameter
We considered comorbidities including hypertension, diabetes, dyslipidemia, stroke, and arthritis; if participants were diagnosed by a doctor and currently under treatment for at least one disease, they were grouped into any comorbidity and others were grouped into non-comorbidity
The majority of participants did not engage in physical activity [16,617 (71.8%)] but more than half of the study sample were active in the labor market: total 61.2% (14,168), men 75.0% (7669), and women 50.3% (6499)
Summary
Concerns about mental health have been growing worldwide and mental health conditions are reported to depend on many factors, including demographic factors [1,2,3] such as socio-economic factors [4,5] and health behaviors, and ecological environmental factors [6,7,8,9].previous studies on the relationships between mental health and associated factors have usually focused on either objective demographic factors including socio-economic conditions, environmental factors, subgroup populations among inpatients, or on specific age groups such as younger generations [8] or the elderly [2,6,10].Already, some studies have reported that perceptions of low social status in adults may be involved in the pathogenesis of depression [4] and an index of socio-economic status seems to predict depression symptomatology across European countries [5]. Concerns about mental health have been growing worldwide and mental health conditions are reported to depend on many factors, including demographic factors [1,2,3] such as socio-economic factors [4,5] and health behaviors, and ecological environmental factors [6,7,8,9]. Previous studies on the relationships between mental health and associated factors have usually focused on either objective demographic factors including socio-economic conditions, environmental factors, subgroup populations among inpatients, or on specific age groups such as younger generations [8] or the elderly [2,6,10]. The health behavior factors may be associated with mental health. Public Health 2017, 14, 431; doi:10.3390/ijerph14040431 www.mdpi.com/journal/ijerph
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