demographic and environmental factors associated with mental health: a cross-sectional study

Abstract

Relevant demographic and environmental conditions need to be understood before tailoring policies to improve mental health. Using community health survey data from 25 communities in Seoul, 2013, cross-sectional associations between mental health and community level environments were assessed. Mental health outcomes (self-rated stress levels (SRS) and depressive symptoms (DS)) were analyzed. Community environmental factors included green space, green facilities, and annual PM10 level (AnnPM10); socio-demographic factors included sex, age, education, labor market participation, comorbidity, sleep hours, physical activity, smoking, and drinking. A total of 23,139 people with the following characteristics participated: men (44.2%); age groups 19−39 (36.0%), 40−59 (39.4%), 60−74 (19.2%), and 75+ (5.4%). Women had higher odds ratios (OR) for SRS [OR 1.22, 95% Confidence interval (CI) 1.17–1.27] and DS [OR 1.55, 95% CI 1.42–1.71]. Regular physical activity predicted SRS [OR 0.90, 95% CI 0.84–0.95] and DS [OR 0.98, 95% CI 0.88–1.10]; current smoking and drinking were adversely associated with both SRS and DS. Higher accessibility to green space (Q4) was inversely associated with DS [OR 0.89, 95% CI 0.81−0.97] compared to lower accessibility (Q1). AnnPM10, annual levels for particles of aerodynamic diameter <10 µm (PM10), among communities was associated with poorer SRS [OR 1.02, 95% CI 1.00–1.04] by 10 μg/m3 increases. Therefore, both demographic and environmental factors should be considered to understand mental health conditions among the general population.