An investigation into the relationship between community engagement and maternal mental health in Calgary, Alberta using the All Our Families cohort.

INTRODUCTION: Existing literature shows that increased community engagement is associated with decreased depressive symptoms. To our knowledge, no existing studies have investigated the relationship between community engagement and adverse mental health among mothers in a Canadian context, nor has this relationship been studied over time. The current study aims to address these gaps by modelling the association between community engagement and anxiety and depression longitudinally using a cohort of prenatal and postnatal mothers living in Calgary, Alberta. METHODS: We used data from the All our Families (AOF) study, a prospective cohort study of expectant and new mothers in Calgary, Alberta from 2008 to 2017 across seven timepoints. We used three-level latent growth curves to model the relationship between individual-level community engagement and maternal depression and anxiety scores, while adjusting for both individual and neighborhood-level characteristics. RESULTS: The study sample consisted of 2129 mothers across 174 neighborhoods in Calgary. Adjusted latent growth curve models demonstrated that community engagement was associated with lower depression (b = - 0.28, 95% CI - 0.33, - 0.23) and anxiety (b = - 0.07, 95% CI - 0.12, - 0.02) scores among mothers over time. DISCUSSION: Adjusted results show that community engagement has a protective effect against depression and anxiety amongst mothers. The results of this study are in line with existing evidence suggesting that social cohesion, civic participation, and community engagement are protective against adverse mental health outcomes.

Exploring the longitudinal associations between census division income inequality and BMI trajectories among Canadian adolescent: Is gender an effect modifier?

Background: Income inequality is a structural determinant of health linked to increased risk of overweight and obesity, although its links to the health of adolescent populations are not well understood. This study investigated the longitudinal associations between census-division-level (CD) income inequality and BMI trajectories among Canadian adolescents, and determine if these associations vary by gender. Methods: Study data are from the Cannabis use, Obesity, Mental health, Physical Activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) cohort of adolescents attending secondary schools in Canada. Our sample included 14,675 adolescents who were followed up across three waves of the COMPASS study (2016-2017, 2017-2018, and 2018-2019) and linked to 30 CDs. Measures of income inequality and other area-level covariates were derived and linked to COMPASS participants using data from the 2016 Canadian Census. We utilized multilevel mixed-effects linear regression modelling to quantify the associations between income inequality and BMI and test for effect modification by gender. Sensitivity analyses were run excluding those with BMI scores in the range considered overweight or obesity at baseline. Results: Higher CD income inequality was significantly associated with higher z-transformed BMI scores (ß = 0.11, 95% CI = 0.034 to 0.19). The interaction term between income inequality and time was not statistically significant, indicating that this association remained constant over time. Once stratified by gender, the association between inequality and BMI became stronger for males (ß = 0.14, 95% CI = 0.060 to 0.022) and attenuated for females (ß = 0.063, 95% CI = -0.047 to 0.17). Conclusion: Attending schools in CDs with higher income inequality was associated with higher BMI scores among male but not female adolescents. Further work is needed to investigate this discrepancy and identify the structural mechanisms that mediate the relationship between inequality and adolescent health.

Inequality's on Tap: A Longitudinal Study of Area-Level Income Inequality and Alcohol Consumption Among Canadian Adolescents.

PURPOSE: To determine if income inequality at the census division level is associated with alcohol consumption and abuse among junior high and high school students. METHODS: Data on adolescents are from the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behavior (COMPASS) study. Participant data (n = 19,759) were collected during three survey waves (2016-2017, 2017-2018, and 2018-2019) and linked to 30 census divisions within four Canadian provinces. Data on income inequality and other area-level factors were derived from the 2016 Canadian census. Multilevel logistic regression modelling was used to quantify the associations between income inequality, monthly alcohol consumption, and binge drinking. RESULTS: After adjusting for covariates, students living in census divisions within the second and third quintiles of income inequality experienced an average 80% (OR = 1.80, 95% CI = 1.08-3.02) and 92% (OR = 1.92, 95% CI = 1.05-3.51) increased odds of engaging in monthly binge drinking, respectively, compared to those living in the first quintile. Similarly, adolescents living in census divisions within the second inequality quintile experienced an average 169% (OR = 2.69, 95% CI = 1.45, 4.99) increased odds of engaging in weekly binge drinking, compared to those living in the first quintile. There was no significant association between higher income inequality and current monthly alcohol consumption. DISCUSSION: Moderate area-level income inequality within census divisions was adversely associated with alcohol consumption among adolescents. Future work should investigate the potential mechanisms that mediate this relationship.