ABSTRACT
Objectives@#Our aim was to answer the following questions: (1) Can mental health variance be partitioned to individual and higher levels (e.g., neighborhood and district); (2) How much (as a percentage) do individual-level determinants explain the variability of mental health at the individual-level; and (3) How much do determinants at the neighborhood- or district-level explain the variability of mental health at the neighborhood- or district-level? @*Methods@#We used raw data from the second round of the Urban Health Equity Assessment and Response Tool in Tehran (in 2012-2013, n=34 700 samples nested in 368 neighborhoods nested in 22 districts) and the results of the official report of Tehran’s Center of Studies and Planning (in 2012-2013, n=22 districts). Multilevel linear regression models were used to answer the study questions. @*Results@#Approximately 40% of Tehran residents provided responses suggestive of having mental health disorders (30-52%). According to estimates of residual variance, 7% of mental health variance was determined to be at the neighborhood-level and 93% at the individual-level. Approximately 21% of mental health variance at the individual-level and 49% of the remaining mental health variance at the neighborhood-level were determined by determinants at the individual-level and neighborhood-level, respectively. @*Conclusions@#If we want to make the most effective decisions about the determinants of mental health, in addition to considering the therapeutic perspective, we should have a systemic or contextual view of the determinants of mental health.
ABSTRACT
Background: Some disaster-stricken people in Iran are still experiencing challenges of resuming normal life several months after the incident. However, there is not sufficient and in-depth understanding of the factors affecting the complex process of post disaster recovery in Iran and rural areas in particular. This study aimed to explore the status of social capital in the process of returning to normal life after an earthquake
Materials and Methods: This study was conducted with the qualitative content analysis method. A total of 20 persons from the earthquake-stricken areas and 7 people with relevant scientific background and expertise were selected via purposeful sampling. Data were collected through semi-structured interviews, focus group discussions, and field notes from August 2013 to January 2014. Data collection continued to achieve data saturation. Data analysis was based on qualitative content analysis
Results: The ignorance of social capital was one of the most significant concepts explored in the process of "back to the normal life" after earthquake. This concept was divided into 4 subcategories of 1] top-down paternalistic approach, 2] undermining of trust, 3] undermining of social networks and self-centering, 4] inefficiency of the social institutions, and 5] social cohesion and social division
Conclusion: This study showed that many reason for ignoring social capital in the process of "back to the normal life" after earthquake should be considered in the recovery management. Policy-makers are suggested to consider a comprehensive plan for using and enhancing the social capital in the process of returning to normal life after earthquakes. This plan can provide an opportunity for rehabilitation after disasters