Differences in depressive symptoms by rurality in Japan: a cross-sectional multilevel study using different aggregation units of municipalities and neighborhoods (JAGES).

IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Mariko Kanamori, Masamichi Hanazato, Daisuke Takagi, Katsunori Kondo, Toshiyuki Ojima, Airi Amemiya, Naoki Kondo
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引用次数: 7

Abstract

Background: Rurality can reflect many aspects of the community, including community characteristics that may be associated with mental health. In this study, we focused on geographical units to address multiple layers of a rural environment. By evaluating rurality at both the municipality and neighborhood (i.e., a smaller unit within a municipality) levels in Japan, we aimed to elucidate the relationship between depression and rurality. To explore the mechanisms linking rurality and depression, we examined how the association between rurality and depression can be explained by community social capital according to geographical units.

Methods: We used cross-sectional data from the 2016 wave of the Japan Gerontological Evaluation Study involving 144,822 respondents aged 65 years or older residing in 937 neighborhoods across 39 municipalities. The population density quintile for municipality-level rurality and the quintile for the time required to reach densely inhabited districts for neighborhood-level rurality were used. We calculated the prevalence ratios of depressive symptoms by gender using a three-level (individual, neighborhood, and municipality) Poisson regression. Community social capital was assessed using three components: civic participation, social cohesion, and reciprocity.

Results: The prevalence of depressive symptoms was higher in municipalities with lower population density than those with the highest population density; the ratios were 1.22 (95% confidence intervals: 1.15, 1.30) for men and 1.22 (1.13, 1.31) for women. In contrast, when evaluating rurality at the neighborhood level, the prevalence of depressive symptoms was 0.9 times lower for men in rural areas; no such association was observed for women. In rural municipalities, community civic participation was associated with an increased risk of depressive symptoms. In rural neighborhoods, community social cohesion and reciprocity were linked to a lower risk of depressive symptoms.

Conclusions: The association between rurality and depression varied according to geographical unit. In rural municipalities, the risk of depression may be higher for both men and women, and the presence of an environment conducive to civic participation may contribute to a higher risk of depression, as observed in this study. The risk of depression in men may be lower in rural neighborhoods in Japan, which may be related to high social cohesion and reciprocity.

Abstract Image

Abstract Image

日本乡村性抑郁症状的差异:一项使用不同城市和社区聚集单位(JAGES)的横断面多层次研究
背景:乡村性可以反映社区的许多方面,包括可能与心理健康有关的社区特征。在这项研究中,我们将重点放在地理单元上,以解决农村环境的多层问题。通过评估日本城市和社区(即城市内较小的单位)水平的乡村性,我们旨在阐明抑郁症与乡村性之间的关系。为探讨乡村性与抑郁之间的联系机制,我们考察了乡村性与抑郁之间的联系如何用社区社会资本来解释。方法:我们使用了2016年日本老年学评估研究浪潮的横断面数据,涉及居住在39个城市937个社区的144,822名65岁或以上的受访者。城市级农村采用人口密度五分位数,社区级农村采用到达人口密集区所需时间五分位数。我们使用三层次(个体、社区和城市)泊松回归计算了按性别划分的抑郁症状患病率。社区社会资本的评估采用三个组成部分:公民参与、社会凝聚力和互惠性。结果:人口密度低的城市抑郁症状患病率高于人口密度高的城市;男性的比值为1.22(95%可信区间:1.15,1.30),女性为1.22(1.13,1.31)。相比之下,当在社区层面评估乡村性时,农村地区男性抑郁症状的患病率低0.9倍;在女性中没有观察到这种联系。在农村城市,社区公民参与与抑郁症状风险增加有关。在农村社区,社区社会凝聚力和互惠性与较低的抑郁症状风险有关。结论:乡村性与抑郁症的关系因地域单位而异。在农村城市,男性和女性患抑郁症的风险可能更高,而有利于公民参与的环境的存在可能导致患抑郁症的风险更高,正如本研究所观察到的那样。在日本农村地区,男性患抑郁症的风险可能较低,这可能与高度的社会凝聚力和互惠性有关。
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来源期刊
International Journal of Health Geographics
International Journal of Health Geographics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
10.20
自引率
2.00%
发文量
17
审稿时长
12 weeks
期刊介绍: A leader among the field, International Journal of Health Geographics is an interdisciplinary, open access journal publishing internationally significant studies of geospatial information systems and science applications in health and healthcare. With an exceptional author satisfaction rate and a quick time to first decision, the journal caters to readers across an array of healthcare disciplines globally. International Journal of Health Geographics welcomes novel studies in the health and healthcare context spanning from spatial data infrastructure and Web geospatial interoperability research, to research into real-time Geographic Information Systems (GIS)-enabled surveillance services, remote sensing applications, spatial epidemiology, spatio-temporal statistics, internet GIS and cyberspace mapping, participatory GIS and citizen sensing, geospatial big data, healthy smart cities and regions, and geospatial Internet of Things and blockchain.
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