Individual and contextual determinants of self-reported poor psychological health: A population-based multilevel analysis in southern Sweden

Objective: To investigate the influence of contextual and individual factors on self-reported psychological health. Design setting?participants/measurements: The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. A total of 13,715 perso...

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Bibliographic Details
Published in:	Scandinavian journal of public health 2006, Vol.34 (4), p.397-405
Main Authors:	LINDSTRÖM, MARTIN, MOGHADDASSI, MAHNAZ, MERLO, JUAN
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Aged Biological and medical sciences Country of origin Cross-Sectional Studies Economic stress Female Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi GHQ12 Health Sciences Health Surveys Humans Hälsovetenskap Male Medical and Health Sciences Medical sciences Medicin och hälsovetenskap Mental Health Middle Aged Miscellaneous ORIGINAL ARTICLES Psychological wellbeing Public health Public Health, Global Health, Social Medicine and Epidemiology Public health. Hygiene Public health. Hygiene-occupational medicine Self Concept self-reported psychological health social capital Social Isolation Social participation Socioeconomic Factors Surveys and Questionnaires Sweden Sweden - epidemiology
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Summary:	Objective: To investigate the influence of contextual and individual factors on self-reported psychological health. Design setting?participants/measurements: The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. A total of 13,715 persons aged 18-80 answered the questionnaire. A multilevel logistic regression model, with individuals at the first level and municipalities/city quarters at the second, was performed. The effect (intraclass correlation, cross-level modification, and odds ratios) of individual and municipality/city quarter factors on selfreported psychological health was analysed. Results: The crude variance between municipalities/city quarters was small but significant. It was particularly affected and lowered by individual civil status, country of origin, economic stress, and social participation. The inclusion of all individual factors age, sex, civil status, country of origin, education, economic stress, and social participation lowered the between municipality variance to not-significant levels, which is the reason why no contextual variables were included in the calculations. Conclusions: The results of this study suggest that poor self-reported psychological health is affected mainly by individual characteristics of the population and not by contextual factors at the municipality/city quarter level.
ISSN:	1403-4948 1651-1905 1651-1905