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Original Articles
Contextual and Individual Determinants of Mental Health: A Cross-sectional Multilevel Study in Tehran, Iran
Homeira Sajjadi, Gholamreza Ghaedamini Harouni, Hassan Rafiey, Mohammadreza Vaez-Mahdavi, Meroe Vameghi, Seyed Hossein Mohaqeqi Kamal
J Prev Med Public Health. 2020;53(3):189-197.   Published online April 14, 2020
DOI: https://doi.org/10.3961/jpmph.19.150
  • 3,656 View
  • 149 Download
  • 4 Crossref
AbstractAbstract PDF
Objectives
Our aim was to answer the following questions: (1) Can mental health variance be partitioned to individual and higher levels (e.g., neighborhood and district); (2) How much (as a percentage) do individual-level determinants explain the variability of mental health at the individual-level; and (3) How much do determinants at the neighborhood- or district-level explain the variability of mental health at the neighborhood- or district-level?
Methods
We used raw data from the second round of the Urban Health Equity Assessment and Response Tool in Tehran (in 2012-2013, n=34 700 samples nested in 368 neighborhoods nested in 22 districts) and the results of the official report of Tehran’s Center of Studies and Planning (in 2012-2013, n=22 districts). Multilevel linear regression models were used to answer the study questions.
Results
Approximately 40% of Tehran residents provided responses suggestive of having mental health disorders (30-52%). According to estimates of residual variance, 7% of mental health variance was determined to be at the neighborhood-level and 93% at the individual-level. Approximately 21% of mental health variance at the individual-level and 49% of the remaining mental health variance at the neighborhood-level were determined by determinants at the individual-level and neighborhood-level, respectively.
Conclusions
If we want to make the most effective decisions about the determinants of mental health, in addition to considering the therapeutic perspective, we should have a systemic or contextual view of the determinants of mental health.
Summary

Citations

Citations to this article as recorded by  
  • This is the place: a multi-level analysis of neighbourhood correlates of adolescent wellbeing
    Jose Marquez, Neil Humphrey, Louise Black, Sophie Wozmirska
    Social Psychiatry and Psychiatric Epidemiology.2024; 59(6): 929.     CrossRef
  • Parental Objective, Subjective, and Contextual Socioeconomic Status and Children's Mental Health in Iran: The Mediating Effect of the Subjective Measure
    Ardavan Mohammad Aghaei, Lawrence Wissow, Ramin Mojtabai, Hadi Zarafshan, Zahra Shahrivar, Amir Hossein Nikzad, Vandad Sharifi
    Iranian Journal of Psychiatry and Behavioral Sciences.2023;[Epub]     CrossRef
  • Multidimensional poverty index: a multilevel analysis of deprivation among Iranian older adults
    Seyed Hossein Mohaqeqi Kamal, Mehdi Basakha, Sabina Alkire
    Ageing and Society.2022; : 1.     CrossRef
  • Measuring and exploring mental health determinants: a closer look at co-residents’ effect using a multilevel structural equations model
    Hend Gabr, Mohammed Baragilly, Brian H. Willis
    BMC Medical Research Methodology.2022;[Epub]     CrossRef
Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models
Kamyar Mansori, Masoud Solaymani-Dodaran, Alireza Mosavi-Jarrahi, Ali Ganbary Motlagh, Masoud Salehi, Alireza Delavari, Mohsen Asadi-Lari
J Prev Med Public Health. 2018;51(1):33-40.   Published online January 2, 2018
DOI: https://doi.org/10.3961/jpmph.17.167
  • 6,586 View
  • 238 Download
  • 7 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models.
Methods
This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The Besag-York-Mollié (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis.
Results
The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively.
Conclusions
Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in atrisk areas.
Summary

Citations

Citations to this article as recorded by  
  • Colorectal cancer spatial pattern in the northeast region of São Paulo, Brazil
    Adeylson Guimarães Ribeiro, Allini Mafra da Costa, Talita Fernanda Pereira, Denise Peixoto Guimarães, José Humberto Tavares Guerreiro Fregnani
    Global Epidemiology.2023; 5: 100097.     CrossRef
  • Impacts of some clinicopathodemography and colorectal tissues key cell cycle and mucin stabilizing molecules on the metastasis trend in colorectal cancer patients
    Ali Ghorbani Ranjbary, Jalil Mehrzad, Nasrollah Rahbar, Hesam Dehghani
    Molecular Biology Reports.2023; 50(10): 8589.     CrossRef
  • Mapping the prevalence of cancer risk factors at the small area level in Australia
    James Hogg, Jessica Cameron, Susanna Cramb, Peter Baade, Kerrie Mengersen
    International Journal of Health Geographics.2023;[Epub]     CrossRef
  • Area-Level Determinants in Colorectal Cancer Spatial Clustering Studies: A Systematic Review
    Sharifah Saffinas Syed Soffian, Azmawati Mohammed Nawi, Rozita Hod, Huan-Keat Chan, Muhammad Radzi Abu Hassan
    International Journal of Environmental Research and Public Health.2021; 18(19): 10486.     CrossRef
  • Favorable colorectal cancer mortality-to-incidence ratios in countries with high expenditures on health and development index
    Chi-Chih Wang, Wen-Wei Sung, Pei-Yi Yan, Po-Yun Ko, Ming-Chang Tsai
    Medicine.2021; 100(41): e27414.     CrossRef
  • Spatial autocorrelation of breast cancer mortality in the Metropolitan Region, Chile: an ecological study
    Doris Durán, María José Monsalves
    Medwave.2020; 20(01): e7766.     CrossRef
  • Premature mortality of gastrointestinal cancer in Iran: trends and projections 2001–2030
    Fatemeh Khosravi Shadmani, Farshad Farzadfar, Moein Yoosefi, Kamyar Mansori, Reza Khosravi Shadman, Aliakbar Haghdoost
    BMC Cancer.2020;[Epub]     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health