The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
BMJ Open. 2022 Apr 29;12(4):e057376. doi: 10.1136/bmjopen-2021-057376.
This study aims to investigate the association of neighbourhood socioeconomic status (SES) and social cohesion (SC) within the neighbourhood with mental health service use in children, independent of individual-level characteristics and mental health problems.
DESIGN, SETTING AND PARTICIPANTS: A longitudinal analysis was done using data from the Generation R Study, a prospective, population-based cohort of children born in Rotterdam, the Netherlands. These data were linked to the Neighbourhood Profile, containing registry and survey data on residents of Rotterdam. Data of 3403 children (mean age: 13.6 years, SD: 0.4) were used to study the associations between neighbourhood SES, SC (SC belonging and SC relations) and mental health service use, adjusted for mental health problems and sociodemographic characteristics.
Mental health service use was reported by the accompanying parent at the research centre using the question: 'Did your child visit a psychologist or psychiatrist between 9 and 13 years old?'.
Mental health services were used by 524 (15.4%) children between ages 9 and 13 years. No significant differences in mental health service use between neighbourhoods were identified (median OR: 1.07 (p=0.50)). The neighbourhood social characteristics were associated with mental health service use, but only when adjusted for each other. Children living in neighbourhoods with a low SES (OR 0.57 (95% CI 0.32 to 1.00)) or high SC belonging (OR 0.79 (95% CI 0.64 to 0.96)) were less likely to use services compared with children in a high SES or low SC belonging neighbourhood. SC relations was not associated with mental health service use.
Our findings indicate that children living in high SES neighbourhoods or in neighbourhoods where people feel less sense of belonging are more likely to use mental health services. As these associations were only present when studied jointly, more research is warranted on the complex associations of neighbourhood factors with children's mental health service use.
本研究旨在探讨邻里社会经济地位（SES）和邻里内社会凝聚力（SC）与儿童心理健康服务使用之间的关联，而不考虑个体水平特征和心理健康问题。
设计、地点和参与者：本研究采用荷兰鹿特丹出生的儿童进行的前瞻性、基于人群的 Generation R 研究的数据进行纵向分析。这些数据与包含鹿特丹居民登记和调查数据的邻里概况相关联。共使用 3403 名儿童（平均年龄：13.6 岁，标准差：0.4）的数据来研究邻里 SES、SC（SC 归属感和 SC 关系）与心理健康服务使用之间的关联，同时调整了心理健康问题和社会人口特征。
在研究中心，由陪同的家长报告心理健康服务使用情况，问题是：“您的孩子在 9 至 13 岁之间是否看过心理学家或精神科医生？”。在 9 至 13 岁之间，有 524 名（15.4%）儿童使用了心理健康服务。在不同邻里之间未发现心理健康服务使用的显著差异（中位数 OR：1.07（p=0.50））。邻里社会特征与心理健康服务使用相关，但仅在相互调整时才如此。与居住在 SES 较高或 SC 归属感较低的邻里的儿童相比，居住在 SES 较低（OR 0.57（95% CI 0.32 至 1.00））或 SC 归属感较高（OR 0.79（95% CI 0.64 至 0.96））的邻里中的儿童不太可能使用服务。SC 关系与心理健康服务使用无关。
我们的研究结果表明，居住在 SES 较高的邻里或居民归属感较低的邻里的儿童更有可能使用心理健康服务。由于这些关联仅在联合研究时存在，因此需要进一步研究邻里因素与儿童心理健康服务使用之间的复杂关联。
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