Association between neighbourhood characteristics and antidepressant use at older ages : a register-based study of urban areas in three European countries

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http://hdl.handle.net/10138/332893

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Tarkiainen , L , Moustgaard , H , Korhonen , K , Noordzij , J M , Beenackers , M A , van Lenthe , F J , Burstrom , B & Martikainen , P 2021 , ' Association between neighbourhood characteristics and antidepressant use at older ages : a register-based study of urban areas in three European countries ' , Journal of Epidemiology & Community Health , vol. 75 , no. 5 , pp. 426–432 . https://doi.org/10.1136/jech-2020-214276

Title: Association between neighbourhood characteristics and antidepressant use at older ages : a register-based study of urban areas in three European countries
Author: Tarkiainen, Lasse; Moustgaard, Heta; Korhonen, Kaarina; Noordzij, J. Mark; Beenackers, Marielle A.; van Lenthe, Frank J.; Burstrom, Bo; Martikainen, Pekka
Contributor: University of Helsinki, Sociology
University of Helsinki, Population Research Unit (PRU)
University of Helsinki, Demography
University of Helsinki, Helsinki Inequality Initiative (INEQ)
Date: 2021-05
Language: eng
Number of pages: 7
Belongs to series: Journal of Epidemiology & Community Health
ISSN: 0143-005X
URI: http://hdl.handle.net/10138/332893
Abstract: Background Research evidence on the association between neighbourhood characteristics and individual mental health at older ages is inconsistent, possibly due to heterogeneity in the measurement of mental-health outcomes, neighbourhood characteristics and confounders. Register-based data enabled us to avoid these problems in this longitudinal study on the associations between socioeconomic and physical neighbourhood characteristics and individual antidepressant use in three national contexts. Methods We used register-based longitudinal data on the population aged 50+ from Turin (Italy), Stockholm (Sweden), and the nine largest cities in Finland linked to satellite-based land-cover data. This included individual-level information on sociodemographic factors and antidepressant use, and on neighbourhood socioeconomic characteristics, levels of urbanicity, green space and land-use mix (LUM). We assessed individual-level antidepressant use over 6 years in 2001-2017 using mixed-effects logistic regression. Results A higher neighbourhood proportion of low-educated individuals predicted lower odds for antidepressant use in Turin and Stockholm when individual-level sociodemographic factors were controlled for. Urbanicity predicted increased antidepressant use in Stockholm (OR=1.02; 95% CI 1.01 to 1.03) together with more LUM (OR=1.03; 1.01-1.05) and population density (OR=1.08; 1.05-1.10). The two latter characteristics also predicted increased antidepressant use in the Finnish cities (OR=1.05; 1.02-1.08 and OR=1.14; 1.02-1.28, respectively). After accounting for all studied neighbourhood and individual characteristics of the residents, the neighbourhoods still varied by odds of antidepressant use. Conclusions Overall, the associations of neighbourhood socioeconomic and physical characteristics with older people's antidepressant use were small and inconsistent. However, we found modest evidence that dense physical urban environments predicted higher antidepressant use among older people in Stockholm and the Finnish cities.
Subject: 5141 Sociology
3142 Public health care science, environmental and occupational health
Mortality
demography
social inequalities
depression
cohort studies
health services
geography
gis
mental health
health behaviour
epidemiology
health inequalities
neighborhood
place
public health
social epidemiology
access to hlth care
inequalities
socio-economic
ageing
registers
marital status
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