Development of the Australian neighborhood social fragmentation index and its association with spatial variation in depression across communities

Nasser Bagheri*, Philip J. Batterham, Luis Salvador-Carulla, Yingxi Chen, Andrew Page, Alison L. Calear, Peter Congdon

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    14 Citations (Scopus)

    Abstract

    Purpose: We know little about how community structures influence the risk of common mental illnesses. This study presents a new way to establish links between depression and social fragmentation, thereby identifying pathways to better target mental health services and prevention programs to the right people in the right place. Method: A principal components analysis (PCA) was conducted to develop the proposed Australian neighborhood social fragmentation index (ANSFI). General practice clinical data were used to identify cases of diagnosed depression. The association between ANSFI and depression was explored using multilevel logistic regression. Spatial hot spots (clusters) of depression prevalence and social fragmentation at the statistical area level 1 (SA1) were examined. Results: Two components of social fragmentation emerged, reflecting fragmentation related to family structure and mobility. Individuals treated for depression in primary care were more likely to live in neighborhoods with lower socioeconomic status and with higher social fragmentation related to family structure. A 1-SD increase in social fragmentation was associated with a 16% higher depression prevalence (95% CI 11%, 20%). However, the association attenuated with adjustment for neighborhood socio-economic status. Considerable spatial variation in social fragmentation and depression patterns across communities was observed. Conclusions: Developing a social fragmentation index for the first time in Australia at a small area level generates a new line of knowledge on the impact of community structures on health risks. Findings may extend our understanding of the mechanisms that drive geographical variation in the incidence of common mental disorders and mental health care.

    Original languageEnglish
    Pages (from-to)1189-1198
    Number of pages10
    JournalSocial Psychiatry and Psychiatric Epidemiology
    Volume54
    Issue number10
    DOIs
    Publication statusPublished - 1 Oct 2019

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