The socio-spatial context as a risk factor for hospitalization due to mental illness in the metropolitan areas of Portugal

Abstract

This study's aims are: (i) identifying spatial patterns for the risk of hospitalization due to mental illness and for the potential risk resulting from contextual factors with influence on mental health; and (ii) analyzing the spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors in the metropolitan areas of Lisbon and Porto, Portugal. A cross-sectional ecological study was conducted by applying statistical methods for assessing spatial dependency and heterogeneity. Results reveal a spatial association between risk of hospitalization due to mental illness and potential risk resulting from contextual factors with a statistical relevance of moderate intensity. 20% of the population under study lives in areas with a simultaneously high potential risk resulting from contextual factors and risk of hospitalization due to mental illness. Porto Metropolitan Area show the highest percentage of population living in parishes with a significantly high risk of hospitalization due to mental health, which puts forward the need for interventions on territory-adjusted contextual factors influencing mental health.

Regional differences in morbidity profiles and health care use in the oldest old: Findings from two Centenarian Studies in Portugal

“…Higher isolation, poor transportation and communications, difficulties to access health and social services are potentially risky conditions for mental health (Loureiro et al, 2015); even though in our study we found a lower percentage of dementia in the rural sample, it should be object of further attention.…”

Population Health Inequalities Across and Within European Metropolitan Areas through the Lens of the EURO-HEALTHY Population Health Index

“…Previous studies also identified the presence of inequalities within these metropolitan areas, although at a more detailed scale [29,35,51]. For example, in the Lisbon case, geographic disparities between municipalities are not evident as expected, considering other studies on health inequalities at the small area level [19,21,27].…”

“…High levels of intra-urban inequalities are also visible as a result of the demographic, economic, environmental, and other societal challenges impacting cities, along with a greater population heterogeneity and different level of access to housing, amenities and services [2,10,13,26]. According to the literature, poor and vulnerable groups are often more at risk due to the concentration on disadvantaged and deprived neighbourhoods, usually in the outskirts of the city or in inner city areas [27,28,29,30]. The Atlas of Population Health in European Union Regions [31], shows that the capital region of each EU country ussually performs better in health determinants (e.g., economic and social conditions, healthcare resources) than in health outcomes.…”

The Association between Material Deprivation and Avoidable Mortality in Lisbon, Portugal

“…Differences regarding the demographic, economic, and environmental characteristics, the different level of access to housing, amenities, and services, and to other societal challenges impacting cities explain the presence of intra-urban inequalities [7,8]. Considering previous studies on European cities, socioeconomic inequalities in health continue to be of greater magnitude in more urbanized communities, where vulnerable people are clustered in impoverished neighborhoods and deprived areas, usually in the suburbs of the city or in inner city areas [9][10][11]. Costa et al [12] observed that municipalities performing worse in health determinants also present worse health outcomes.…”