The impact of urbanization on mental health service provision

Robertson, Lesley

doi:10.1097/yco.0000000000000495

Cited by 10 publications

(6 citation statements)

References 33 publications

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“…On the one hand, the fact of this finding is contrary to the common belief that most people believe individuals living in the countryside are less prone to depression (13), which could be explained by several reasons. In most high-income countries, compared with urban areas, rural residents who haven't experienced urbanization are exposed to less economic stress or environmental hazards (16,17) and the violent crime rate is lower (35), resulting in a lower risk of depression. In low-income countries, compared to urban residents, rural residents are disadvantaged in socioeconomic status and access to health services, especially mental health services (12).…”

Section: Discussionmentioning

confidence: 99%

“…On the one hand, it provides protective health opportunities, especially for people with depression, such as better living conditions, infrastructure development and access to health care (13)(14)(15). On the other hand, it is also associated with a range of factors that can further increase depression risk due to rapid and unplanned urbanization progress, including poor quality of healthcare, economic pressure and environmental hazards (16,17). In the past decade, China has been rapidly urbanized, with a proportion of 49.68% in 2010 to 63.89% in 2020, far exceeding that of other countries.…”

Section: Introductionmentioning

confidence: 99%

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Urbanization and depressive symptoms among middle-aged and older adults in China

Hong

Xiong²,

et al. 2022

Front. Public Health

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AimsUrbanization plays an important role in individuals' health. However, it is difficult to isolate healthy migrant effect between urbanization and health. This study examined the effects of urbanization on depressive symptoms and its possible pathways among Chinese middle-aged and older adults independent of the influence of health-selective migration.MethodsUsing the baseline survey of the China Health and Retirement Longitudinal Study, this study compared the depressive symptoms among three groups (urbanized rural residents, rural non-migrants and urban non-migrants). The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) short form was used to measure depressive symptoms. Logistic regression models and Structural Equation Model (SEM) were applied to examine the association between urbanization and depressive symptoms and the corresponding potential mechanisms.ResultsOur final sample contained 11,156 respondents with an average age of 58.91 (SD = 9.48), with 5,142 males (46.09%) and 6,014 females (53.91%). Compared with urbanized rural residents, rural residents were more likely to have depressive symptoms (OR = 1.19, 95% CI = 1.07, 1.32), and urban residents were associated with a decreased risk of depressive symptoms (OR = 0.81, 95% CI: 0.70, 0.94). A large proportion of the association between urbanization and depressive symptoms were mainly mediated by social participation, income and living conditions.ConclusionsPlanned urbanization had an independent impact on decreased depressive symptoms. Improvements in social participation, income and living conditions are the main drivers behind this relationship. Additionally, urbanization compensates for the negative impact of depressive symptoms from disadvantaged early life conditions, but it cannot eliminate the gap between urbanized rural people and urban non-migrants.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Urbanization and depressive symptoms among middle-aged and older adults in China

Hong

Xiong²,

et al. 2022

Front. Public Health

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“…Urbanization consistently reported to be associated with mental disorders [21]. In rural areas, resources for treating mental disorders are more likely to be limited [28]. To attenuate the risk of Internet addiction among adolescents in both rural and urban areas, the health authority should establish adequate mental health resources for early assessment and treatment for mental disorder, including Internet addiction.…”

Section: Effects Of Urbanization On Internet Addiction Preventionmentioning

confidence: 99%

Association between urbanization and Internet addiction

Yen

Lin

2022

Current Opinion in Psychiatry

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Purpose of reviewUnderstanding the association between urbanization and Internet addiction is essential to the design and implementation of Internet addiction prevention measures in urban areas. This epidemiological review explores the urbanization-Internet addiction association and its potential underlying factors. Recent findingsNine studies have reported that Internet addiction prevalence is higher in urban areas, but three studies have noted the opposite. Psychiatric disorders and stress are the most commonly mentioned factors underlying the association. The effects of urbanization on Internet availability, Internet cafes, online gaming, outdoor or interactive activities, and family regulation and monitoring have been suggested to lead to higher Internet addiction risk. The ongoing COVID-19 pandemic, obesity, sleep problems, and the migration of parents to urban areas in search of work have strengthened the effect of urbanization on Internet addiction. SummaryEarly assessment and treatment provided by mental health services are crucial for mitigating the effect of urbanization on Internet addiction risk. Cities should be designed to provide adequate space for physical and interactive activities. To promote outdoor activities, air pollution, traffic congestion, and crime should be controlled. Prospective face-to-face studies involving analysis of data on pollution, traffic, and Internet addiction could provide evidence to elucidate the urbanization-Internet addiction association.

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“…Longitudinal studies examining residence in early life before the onset of psychosis (March et al, 2008 ) suggest that this finding cannot be explained solely by social drift (Pedersen, 2015 ) – in other words, the hypothesis that people who are vulnerable to psychotic disorders tend to migrate to more urban areas, or are unable to move out of them – and there is evidence of a cumulative effect of exposure to urban environment during childhood (Pedersen & Mortensen, 2001 ). Since the proportion of the global population that lives in urban settings is rapidly increasing, and 68% of the world's people are projected to live in cities by 2050 according to UN projections (United Nations, 2018 ), it is imperative that we understand the mechanisms underlying the association between urbanicity and psychosis, particularly in countries that are set to account for a large proportion of this growth, such as India and Nigeria (Robertson, 2019 ), and identify modifiable risk factors to avert corresponding increases in psychotic disorders.…”

Section: Introductionmentioning

confidence: 99%

Urbanicity and rates of untreated psychotic disorders in three diverse settings in the Global South

et al. 2023

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Background Extensive evidence indicates that rates of psychotic disorder are elevated in more urban compared with less urban areas, but this evidence largely originates from Northern Europe. It is unclear whether the same association holds globally. This study examined the association between urban residence and rates of psychotic disorder in catchment areas in India (Kancheepuram, Tamil Nadu), Nigeria (Ibadan, Oyo), and Northern Trinidad. Methods Comprehensive case detection systems were developed based on extensive pilot work to identify individuals aged 18–64 with previously untreated psychotic disorders residing in each catchment area (May 2018–April/May/July 2020). Area of residence and basic demographic details were collected for eligible cases. We compared rates of psychotic disorder in the more v. less urban administrative areas within each catchment area, based on all cases detected, and repeated these analyses while restricting to recent onset cases (<2 years/<5 years). Results We found evidence of higher overall rates of psychosis in more urban areas within the Trinidadian catchment area (IRR: 3.24, 95% CI 2.68–3.91), an inverse association in the Nigerian catchment area (IRR: 0.68, 95% CI 0.51–0.91) and no association in the Indian catchment area (IRR: 1.18, 95% CI 0.93–1.52). When restricting to recent onset cases, we found a modest positive association in the Indian catchment area. Conclusions This study suggests that urbanicity is associated with higher rates of psychotic disorder in some but not all contexts outside of Northern Europe. Future studies should test candidate mechanisms that may underlie the associations observed, such as exposure to violence.

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The impact of urbanization on mental health service provision

Cited by 10 publications

References 33 publications

Urbanization and depressive symptoms among middle-aged and older adults in China

Urbanization and depressive symptoms among middle-aged and older adults in China

Association between urbanization and Internet addiction

Urbanicity and rates of untreated psychotic disorders in three diverse settings in the Global South

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