Neighborhood-Level Social Determinants of Health and Adolescent Mental Health.

Autor: Oyegoke S; Texas College of Osteopathic Medicine (S Oyegoke), University of North Texas Health Science Center, Fort Worth, Texas., Hughes PM; Division of Pharmaceutical Outcomes and Policy (PM Hughes), University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC; Division of Research (PM Hughes), UNC Health Sciences at MAHEC, Asheville, NC; Cecil G. Sheps Center for Health Services Research (PM Hughes), University of North Carolina, Chapel Hill, NC., Gigli KH; University of Texas at Arlington College of Nursing and Health Innovation Arlington (KH Gigli), Arlington, Texas. Electronic address: Kristin.gigli@uta.edu.
Jazyk: angličtina
Zdroj: Academic pediatrics [Acad Pediatr] 2024 Nov-Dec; Vol. 24 (8), pp. 1246-1255. Date of Electronic Publication: 2024 Aug 17.
DOI: 10.1016/j.acap.2024.08.008
Abstrakt: Objective: Mental health diagnoses among adolescents are increasing in prevalence. Existing literature considers associations between individual-level social determinants of health (SDOH) and adolescent mental health. Neighborhood-level SDOH can have a substantial impact on health. This paper examines associations between neighborhood-level SDOH and mental health diagnoses of anxiety, depression, and suicidal ideation among hospitalized adolescents.
Methods: We used 2018 and 2019 Texas Inpatient Discharge Public Use Data Files linked to the zip-code level Child Opportunity Index 2.0, a composite measure of subdomains which characterize neighborhood-level SDOH, to examine rates of mental health diagnoses and associations with patient characteristics across opportunity level quintiles.
Results: The sample included 50,011 adolescents ages 10-19 admitted to the hospital with the mental health diagnoses anxiety, depression, and/or suicide. Most had a single diagnosis; anxiety (12.9%), depression (37.5%), or suicide (13.0%). Hospitalized adolescents 10-14 years old were a plurality (44.2%) of the sample. Most adolescents were White (64.2%) and non-Hispanic (67.4%) and lived in rural areas (29.6%). Adolescents from racial minority populations and those in rural communities with mental health diagnoses had lower opportunity-levels. Higher opportunity levels were associated with greater odds of having an anxiety or suicide diagnosis while a depression diagnosis was associated with a lower opportunity-level.
Conclusions: There are significant differences in adolescent mental health diagnoses associated with neighborhood opportunity-level. While all adolescents can benefit from mental health education, screening, and early interventions, additional resources tailored to neighborhood-level opportunity may prove a more meaningful way to improve population-level mental health outcomes.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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