Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population

Neeru Gupta, Dan Lawson Crouse, Ismael Foroughi and Thalia Nikolaidou
Additional contact information
Neeru Gupta: Department of Sociology, University of New Brunswick, PO Box 4400, Fredericton, NB E3B 5A3, Canada
Dan Lawson Crouse: Health Effects Institute, Boston, MA 02110, USA
Ismael Foroughi: Department of Sociology, University of New Brunswick, PO Box 4400, Fredericton, NB E3B 5A3, Canada
Thalia Nikolaidou: Department of Geodesy and Geomatics Engineering, University of New Brunswick, PO Box 4400, Fredericton, NB E3B 5A3, Canada

IJERPH, 2021, vol. 18, issue 21, 1-11

Abstract: Background: Little is known about the extent to which socioenvironmental characteristics may influence mental health outcomes in smaller population centres or differently among women and men. This study used a gender-based analysis approach to explore individual- and neighbourhood-level sex differences in mental health service use in a context of uniquely smaller urban and rural settlements. Methods: This cross-sectional analysis leveraged multiple person-based administrative health datasets linked with geospatial datasets among the population aged 1 and over in the province of New Brunswick, Canada. We used multinomial logistic regression to examine associations between neighbourhood characteristics with risk of service contacts for mood and anxiety disorders in 2015/2016, characterizing the areal measures among all residents (gender neutral) and by males and females separately (gender specific), and controlling for age group. Results: Among the province’s 707,575 eligible residents, 10.7% (females: 14.0%; males: 7.3%) used mental health services in the year of observation. In models adjusted for gender-neutral neighbourhood characteristics, service contacts were significantly more likely among persons residing in the most materially deprived areas compared with the least (OR = 1.09 [95% CI: 1.05–1.12]); when stratified by individuals’ sex, the risk pattern held for females (OR = 1.13 [95% CI: 1.09–1.17]) but not males (OR = 1.00 [95% CI: 0.96–1.05]). Residence in the most female-specific materially deprived neighbourhoods was independently associated with higher risk of mental health service use among individual females (OR = 1.08 [95% CI: 1.02–1.14]) but not among males (OR = 1.02 [95% CI: 0.95–1.10]). Conclusion: These findings emphasize that research needs to better integrate sex and gender in contextual measures aiming to inform community interventions and neighbourhood designs, notably in small urban and rural settings, to reduce socioeconomic inequalities in the burden of mental disorders.

Keywords: socioenvironmental determinants of health; mental health services research; gender and health; population health surveillance; residence characteristics; spatial epidemiology; data linkage (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:21:p:11197-:d:664328

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