Abstract
This study's aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.
Highlights
Mental health is an essential component of one’s wellbeing 1; mental disorders are currently one of the main causes of impairment, and high rates or morbidity and mortality 2, prematurely
This study’s aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal
Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness
Summary
Mental health is an essential component of one’s wellbeing 1; mental disorders are currently one of the main causes of impairment, and high rates or morbidity and mortality 2, prematurely. There is growing scientific interest in the study of the relationship between context (considered as the setting of residence/work/teaching/leisure) and health, and in the influence of context as a trigger of health inequalities. The risk of mental disorders is influenced by the interaction between biological, psychological, social, environmental and institutional factors 1, which means that the social-environmental characteristics of the place where one is born, raised, lives, works and grows old influence individual and collective mental health [32,33,34] A number of authors have suggested that contextual conditions, such as poverty/deprivation [5,6,7,8,9], income [10,11,12], occupation 13 (e.g. manual and non-manual labor), employment/ unemployment [9,13,14,15,16,17], housing [18,19,20,21] (e.g. overcrowding), physical and built environment [12,18,22,23,24] (e.g. air and water pollution, green areas), access to equipment and services 25 (e.g. health, education, social support, sports and leisure), mobility and transportation 26, education 27, capital and social cohesion [28,29] (e.g. identity, trust in the institutions), social exclusion 30 (e.g. isolation, racism and discrimination), and safety [26,31] (e.g. public safety, crime and violence) impact the mental health of the population.
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