Residential segregation, dividing walls and mental health: a population-based record linkage study

Abstract

BackgroundNeighbourhood segregation has been described as a fundamental determinant of physical health, but literature on its effect on mental health is less clear. While most previous research has relied on conceptualised measures of segregation, Northern Ireland is unique as it contains physical manifestations of segregation in the form of segregation barriers (or ‘peacelines’) which can be used to accurately identify residential segregation.MethodsWe used population-wide health record data on over 1.3 million individuals, to analyse the effect of residential segregation, measured by both the formal Dissimilarity Index and by proximity to a segregation barrier, on the likelihood of poor mental health.ResultsUsing multilevel logistic regression models, we found residential segregation measured by the Dissimilarity Index poses no additional risk to the likelihood of poor mental health after adjustment for area-level deprivation. However, residence in an area segregated by a ‘peaceline’ increases the likelihood of antidepressant medication by 19% (OR=1.19, 95% CI 1.14 to 1.23) and anxiolytic medication by 39% (OR=1.39, 95% CI 1.32 to 1.48), even after adjustment for gender, age, conurbation, deprivation and crime.ConclusionsLiving in an area segregated by a ‘peaceline’ is detrimental to mental health suggesting segregated areas characterised by a heightened sense of ‘other’ pose a greater risk to mental health. The difference in results based on segregation measure highlights the importance of choice of measure when studying segregation.

Factors Associated with Mortality Including Nursing Home Transitions: A Retrospective Analysis of 25,418 People Prescribed Anti-Dementia Drugs in Northern Ireland

“…The NIMDM ranges from 1-10, with lower values indicating higher levels of deprivation. Previous work in NI has indicated that people with lower NIMDM scores have higher levels of mental illness and poorer mental health [40]. Moreover, recent research which looked at nationwide data of PwD between 2000 and 2010 has shown that both males and females with dementia who lived in more deprived areas had higher levels of mortality in comparison to PwD who lived in less deprived areas [41].…”

Diverse neighbourhoods: an analysis of the residential distribution of immigrants in Ireland

“…Work by Maguire et al (2016) reflects a growing awareness in recent years of how important the spatial interface between different groups can be. It is not only the overall degree of spatial separation that matters but also the nature of transitions between residential communities.…”

Consanguineous Marriage and the Psychopathology of Progeny

“…This method has been validated in previous studies. 43,44 Owing to small numbers in each of the consanguinity categories, measures of area deprivation and area rurality were added to the multilevel models separately to ensure convergence. Third, as per the method above, multilevel multivariable regression models were constructed to estimate the likelihood of psychotropic medication use given the degree of parental consanguinity.…”