NIHR School for Primary Care Research, Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.
Manchester Academic Health Sciences Centre [MAHSC], Manchester, UK.
BMJ Open. 2019 Jan 24;9(1):e025881. doi: 10.1136/bmjopen-2018-025881.
Social fragmentation is commonly examined in epidemiological studies of mental illness as high levels of social fragmentation are often found in areas with high prevalence of mental illness. In this study, we examine spatial and temporal patterns of social fragmentation and its underlying indicators in England over time.
Data for social fragmentation and its underlying indicators were analysed over the decennial Censuses (2001-2011) at a small area geographical level (mean of 1500 people). Degrees of social fragmentation and temporal changes were spatially visualised for the whole of England and its 10 administrative regions. Spatial clustering was quantified using Moran's I; changes in correlations over time were quantified using Spearman's ranking correlation.
Between 2001 and 2011, we observed a strong persistence for social fragmentation nationally (Spearman's r=0.93). At the regional level, modest changes were observed over time, but marked increases were observed for two of the four social fragmentation underlying indicators, namely single people and those in private renting. Results supported our hypothesis of increasing spatial clustering over time. Moderate regional variability was observed in social fragmentation, its underlying indicators and their clustering over time.
Patterns of social fragmentation and its underlying indicators persisted in England which seem to be driven by the large increases in single people and those in private renting. Policies to improve social cohesion may have an impact on the lives of persons who experience mental illness. The spatial aspect of social fragmentation can inform the targeting of health and social care interventions, particularly in areas with strong social fragmentation clustering.
社会碎片化在精神疾病的流行病学研究中经常被考察，因为在精神疾病高发地区通常会发现高水平的社会碎片化。在这项研究中，我们考察了英国社会碎片化及其潜在指标随时间的空间和时间模式。
在小区域地理水平（平均 1500 人）上，对社会碎片化及其潜在指标的数据进行了分析，时间跨度为十年一次的人口普查（2001-2011 年）。对全英格兰及其 10 个行政区的社会碎片化程度和时间变化进行了空间可视化。使用 Moran's I 量化空间聚类；使用 Spearman 等级相关系数量化随时间变化的相关性变化。
在 2001 年至 2011 年间，我们观察到全国范围内社会碎片化具有很强的持续性（Spearman 的 r=0.93）。在区域层面上，随着时间的推移观察到适度的变化，但四个社会碎片化潜在指标中的两个指标，即单身人士和私人租房者的变化明显增加。结果支持我们关于随时间增加空间聚类的假设。社会碎片化、其潜在指标及其随时间的聚类在区域间存在适度的变异性。
英格兰的社会碎片化及其潜在指标的模式持续存在，这似乎是由单身人士和私人租房者的大量增加所驱动的。改善社会凝聚力的政策可能会对经历精神疾病的人的生活产生影响。社会碎片化的空间方面可以为健康和社会保健干预措施的定位提供信息，特别是在社会碎片化聚类较强的地区。
