Low-linking social capital as a predictor of mental disorders: a cohort study of 4.5 million Swedes.

Few previous studies have analyzed the association between different dimensions of social capital and mental disorders. This study examines whether there is an association between a relatively new theoretical concept describing the amount of trust between individuals and societal institutions, i.e. linking social capital, and hospitalization due to depression or psychosis. The entire Swedish population aged 25-64, a total of 4.5 million men and women, was followed from January 1, 1997, until the first hospital admission due to depression or psychosis during the study period, or the end of the study on December 31, 1999. Small area neighborhood units were used to define neighborhoods. The definition of linking social capital was based on mean voting participation in each neighborhood unit, categorized in tertiles. Multilevel logistic regression was used to estimate odds ratios and neighborhood-level variance in four different models. The results showed strong associations between linking social capital and hospitalization due to depression or psychosis. These associations decreased considerably in both men and women, but still remained significant, after adjustment for age, housing tenure, education, employment status, marital status, and country of birth. However, the results for depression (both men and women) no longer remained significant after adjustment for neighborhood deprivation. In contrast, the results for psychosis decreased considerably but remained significant after adjustment for neighborhood deprivation. The association between low levels of voting participation and hospitalization due to depression or psychosis might reflect neighborhood differences in linking social capital, which could affect vulnerable individuals negatively. Decision-makers should take into account the evidence of a neighborhood effect on mental health in decisions regarding the sites of psychiatric clinics and other kinds of community support for psychiatric patients.

Neighbourhood income and anxiety: a study based on random samples of the Swedish population.

BACKGROUND: Few studies have investigated the association between the neighbourhood characteristics and the vast panorama of mental disorders. This study examined whether there is an association between neighbourhood income and anxiety, a common mental disorder. METHODS: A national random sample of the entire Swedish population was used, consisting of 30 884 men and women aged 25-64 years. The sample was obtained from pooled data during the period 1995-2002 from the Swedish Annual Level of Living Survey. Small area market statistics were used in order to define neighbourhoods. The proportion of individuals with incomes in the lowest national income quartile was calculated for each neighbourhood. The distribution was then divided into quartiles. A log binomial model was applied in the estimation of prevalence ratios. Four models were calculated with stepwise inclusion of the variables. Model 4 was adjusted for all the individual variables, i.e. age, gender, marital status, immigrant status, social network, housing tenure, employment status, and income. RESULTS: In neighbourhoods with the highest proportions of individuals with low income the prevalence ratio of anxiety was 1.33 (95% confidence interval 1.24-1.42). The association demonstrated between neighbourhood income and anxiety decreased after stepwise inclusion of the individual variables and disappeared after all the individual variables were accounted for. CONCLUSION: Compositional explanations, rather than contextual explanations, lie behind the association between neighbourhood income and anxiety, a common mental disorder. However, we do not exclude the possibility that there is a contextual effect on severe mental disorders or among children with behavioural problems.