An exploration of factors characterising unusual spatial clusters of COVID-19 cases in the East Midlands region, UK: A geospatial analysis of ambulance 999 data

Characterizing Unusual Spatial Clusters of Male Mental Health Emergencies Occurring During the First National COVID-19 “Lockdown” in the East Midlands Region, UK: A Geospatial Analysis of Ambulance 999 Data

“…In contrast to studies that utilize self-reporting and help-seeking service use data, Moore et al (2021) analyzed ambulance records of mental health emergencies that occurred during the first national “lockdown” from the East Midlands Ambulance Service NHS Trust (EMAS) and reported that compared to the same period in 2019, males rather than females were more likely to experience mental health emergencies attended by ambulances. In a recent study appearing in this special edition ( Disparate Impact of COVID-19 on Men’s Health ), Moore, Siriwardena, Gussy, et al (2022) investigated the characteristics of males presenting with mental health emergencies to ambulance services in the East Midlands of the United Kingdom and reported that greater numbers of males were attended by ambulance for acute anxiety during “lockdown” compared to the same period in 2019, and they were more likely to live in the most deprived regions of the East Midlands compared with females. In the current study, we consider the spatial dynamics of males presenting with mental health emergencies attended by ambulances whereby paramedics record a preliminary diagnosis of conditions including severe anxiety and depression (see subsection “Measures” for in depth details about diagnosis).…”

“…Importantly, social and environmental factors interact within the landscapes that societies inhabit ( Curtis et al, 2006 ). Severe health outcomes, including physical ( Moore, Hill, Siriwardena, Law, et al, 2022 , Moore, Hill, Siriwardena, Tanser, & Spaight, 2022 ) and mental health conditions ( Evans & Cassells, 2014 ; Repetti et al, 2002 ) are often the result of cumulative stressors occurring across these domains. Mental health emergencies, such as attempted suicide, are more likely to occur after multiple successive negative experiences; successive experiences create conditions of underlying susceptibility , while major life events, like extended periods of social isolation can act as triggers escalating a mental health condition and precipitating an emergency situation ( Kegler et al, 2017 ; Kira et al, 2019 ).…”

“…However, the characteristics of communities associated with health-related emergencies vary according to geographic location. For example, Moore, Hill, Siriwardena, Law, et al (2022) investigated the characteristics of regions with unusual clusters of suspected severe COVID-19 and identified that features of communities with high rates of severe cases varied depending on degree of urbanization and rurality, as well as location inland compared with coastal areas. Risk factors in urban areas were associated with deprivation whereas risk factors in rural areas were related to isolation from health services.…”

“…In this study, we utilize the analytical methodology developed by Moore, Hill, Siriwardena, Law, et al (2022) to identify regions with unusually high clusters of male mental health emergencies during the first national “lockdown” in the United Kingdom, and to consider the socioeconomic and landscape features that explain the location of those clusters. In the case of a contagious disease such as COVID-19, clusters of severe illness reflect the intersection of individual exposure to the virus and underlying health susceptibility.…”

“…Our analysis demonstrated that social and physical features of built environments are associated with vulnerability to severe illness from infectious disease. Thus, we proposed that, “physical landscape factors rightly belong in a theoretical space akin to Bronfenbrenner’s Mesosystem” ( Moore, Hill, Siriwardena, Law, et al, 2022 ). Similar to infectious disease, mental health outcomes are associated with social factors, such as deprivation ( Drukker & van Os, 2003 ; Gunnell et al, 1995 ), and physical environmental factors, such as access to services that facilitate help-seeking ( Gulliford et al, 2002 ), and green and blue spaces that promote well-being ( Daras et al, 2019 ).…”