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Poor Quality Urban Infrastructure: A Mental Health Risk Factor - Perspectives from a Small Island Developing State
Methods: Secondary analysis was conducted from the Jamaica Health and Lifestyle Survey 2007/8, a nationally representative sample of 2848 Jamaicans 15 – 74 years. Neighbourhood scales were developed to measure the availability and quality of infrastructure, services, neighbourhood socioeconomic status and green spaces. Depressive symptoms were measured using the Diagnostic and Statistical Manual of Mental Disorders (DSMIV). Data were analyzed using STATA 12. Multivariate logistic regression models controlled for individual socio-economic and health status.
Results: The national burden of depressive symptoms was 20%, with poor quality urban environments being associated with poor mental health. However, men and women were impacted by different aspects of urban environments. Among men, it was the poor quality of the neighbourhood infrastructure (OR 1.92 CI 1.05, 3.52), whilst among women, residence in informal/unplanned settlements doubled their risk (OR 2.09 CI 1.15, 3.82). There were no neighbourhood associations in rural Jamaica.
Conclusion: Residents of poor quality urban neighbourhoods face an increased risk of depressive symptoms. Managing the effects of the neighbourhood is important as depressive symptoms occur frequently and are associated with significant economic and social costs. Local planning authorities should urgently implement innovative, community-based solutions for urban renewal through multi-sectoral engagement to achieve improved planning, organization and infrastructure of communities. The neighbourhood risk may be compounded by the sustainable development challenges and the impact of climate change faced by SIDS. Further studies of urban environments and depression in other small island developing states, including the Caribbean are needed to confirm these findings.
Learning Areas:
Environmental health sciencesEpidemiology
Implementation of health education strategies, interventions and programs
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Learning Objectives:
Assess the contribution of the urban neighbourhood to mental health
Discuss the implications of the neighbourhood risk for urban planning and social support programing
Describe the complexities of small island developing states and how these may contribute to mental health in these settings
Keyword(s): Built Environment, Mental Health
Qualified on the content I am responsible for because: This work was conducted for my PhD in Epidemiology (2013) which focused on examining the effect of the neighbourhood on depressive symtpoms in the Jamaican population. My research interest is urban health, with reference to the contribution of the neighbourhood, a newly developing research area within the Caribbean. My work adds value to the literature and has significant potential to inform public policy, having identified the specific neighbourhood contributors to poor mental health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.