Small area-level variation in the incidence of psychotic disorders in an urban area in France: an ecological study

2016 ◽  
Vol 51 (7) ◽  
pp. 951-960 ◽  
Author(s):  
Andrei Szoke ◽  
Baptiste Pignon ◽  
Grégoire Baudin ◽  
Andrea Tortelli ◽  
Jean-Romain Richard ◽  
...  
Keyword(s):  
Urban Area ◽  
Small Area ◽  
Ecological Study ◽  
Psychotic Disorders ◽  
Level Variation ◽  
Small Area Level

scholarly journals A multilevel mixed effects analysis of informal carers health in Australia: the role of community participation, social support and trust at small area level

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Itismita Mohanty ◽  
Theo Niyonsenga ◽  
Tom Cochrane ◽  
Debra Rickwood
Keyword(s):  
Health Outcomes ◽  
Community Participation ◽  
General Health ◽  
Small Area ◽  
Positive Influence ◽  
Mixed Effects ◽  
Level Variation ◽  
Individual Level ◽  
Small Area Level ◽  
Informal Carers

Abstract Background Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with individual level variation in carers’ health outcomes. Methods The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The sample consisted of 12,767 individuals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life. Results Informal carers suffered from poor mental (Beta = − 0.587, p = 0.003) and general health (Beta = − 0.670, p = 0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12–13% variation in general and mental health. However, within small local areas, differences at the individual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by individuals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.

scholarly journals O1.3. BACK TO THE FUTURE: PREDICTING POPULATION NEED FOR PSYCHOSIS CARE BASED ON THE EPIDEMIOLOGY OF PSYCHOTIC DISORDERS IN ENGLAND, AN APPLIED BAYESIAN METHODOLOGY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S1-S2
Author(s):  
Keltie McDonald ◽  
Tao Ding ◽  
Rebecca Dliwayo ◽  
David Osborn ◽  
Pia Wohland ◽  
...  
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Small Area ◽  
Psychotic Disorders ◽  
Population Projections ◽  
First Episode ◽  
Evidence Based ◽  
Psychosis Risk ◽  
Small Area Level ◽  
Early Intervention In Psychosis

Abstract Background Providing timely, adequate and appropriately-resourced care to people experiencing their first episode of psychosis needs to be informed by evidence-based models of future need in the population. We sought to develop a validated prediction model of need for provision of early intervention in psychosis [EIP] services at the small area level in England up to 2025, based on current epidemiological evidence and demographic projections of the at-risk population. Methods We developed a Bayesian population-level prediction tool. First, we obtained small area incidence data on first episode psychoses, aged 16–64 years, from three major empirical studies of psychosis risk (ÆSOP, ELFEP and SEPEA). Second, we identified suitable prior information from the published literature on variation in psychosis risk by age, sex, ethnicity, deprivation and cannabis use. Third, we combined this empirical data with prior beliefs in six Bayesian Poisson regression models to obtain a full characterisation of the underlying uncertainty in the form of suitable posterior distributions for the relative risks for different permutations of covariate data. Fourth, model coefficients were applied to population projections for 2017 to predict the expected incidence of psychotic disorders, aggregated to Commissioning Group [CCG] and national levels. Fifth, we compared these predictions to observed national FEP data from the NHS Mental Health Services Data Set in 2017 to establish the most valid model. Sixth, we used the best-fitting model to predict three nested indicators of need for psychosis care: (i) total annual referrals to early intervention in psychosis [EIP] for “suspected” FEP (ii) total annual cases accepted onto EIP service caseloads, and (iii) total annual new cases of probable FEP in England up until 2025, using small area population projections. Results A model with an age-sex interaction, ethnicity, small area-level deprivation, social fragmentation and regional cannabis use provided best internal and apparent validity, predicting 8112 (95% Credible Interval 7623 to 8597) individuals with FEP in England in 2017, compared with 8038 observed cases (difference: n=74; 0.94%). Apparent validity was acceptable at CCG level, and by sex and ethnicity, although we observed greater-than-expected need before 35 years old. Predicted new referrals, caseloads and probable incidences of FEP rose over the forecast period by 6.2% to 25,782, 23,187 and 9,541 new cases in 2025, respectively. Discussion Our translational epidemiological tool provides an accurate, validated method to inform planners, commissioners and providers about future population need for psychosis care at different stages of the referral pathway, based on individual and small area level determinants of need. Such tools can be used to underpin evidence-based decision-making in public mental health and resource allocation in mental health systems.

scholarly journals A Multilevel Mixed Effects Analysis of Informal Carers Health in Australia: The role of Community Participation, Social Support and Trust at Small Area level.

2020 ◽  
Author(s):  
Itismita Mohanty ◽  
Theo Niyonsenga ◽  
Tom Cochrane ◽  
Debra Rickwood
Keyword(s):  
Health Outcomes ◽  
Community Participation ◽  
General Health ◽  
Small Area ◽  
Positive Influence ◽  
Mixed Effects ◽  
Level Variation ◽  
Individual Level ◽  
Small Area Level ◽  
Informal Carers

Abstract Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with individual level variation in carers’ health outcomes.Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The sample consisted of 12,767 individuals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life.Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the individual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by individuals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.

scholarly journals Outdoor air pollution, mortality, and hospital admissions from coronary heart disease in Sheffield, UK: a small-area level ecological study

2005 ◽  
Vol 26 (23) ◽  
pp. 2543-2549 ◽  
Author(s):  
Ravi Maheswaran ◽  
Robert P. Haining ◽  
Paul Brindley ◽  
Jane Law ◽  
Tim Pearson ◽  
...  
Keyword(s):  
Air Pollution ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Small Area ◽  
Ecological Study ◽  
Hospital Admissions ◽  
Outdoor Air ◽  
Outdoor Air Pollution ◽  
Small Area Level

scholarly journals Outdoor air pollution, subtypes and severity of ischemic stroke – a small-area level ecological study

2014 ◽  
Vol 13 (1) ◽  
pp. 23 ◽  
Author(s):  
Ravi Maheswaran ◽  
Tim Pearson ◽  
Sean D Beevers ◽  
Michael J Campbell ◽  
Charles D Wolfe
Keyword(s):  
Air Pollution ◽  
Ischemic Stroke ◽  
Small Area ◽  
Ecological Study ◽  
Outdoor Air ◽  
Outdoor Air Pollution ◽  
Small Area Level

scholarly journals A Multilevel Mixed Effects Analysis of Informal Carers Health in Australia: The role of Community Participation, Social Support and Trust at Small Area level.

2020 ◽  
Author(s):  
Itismita Mohanty ◽  
Theo Niyonsenga ◽  
Tom Cochrane ◽  
Debra Rickwood
Keyword(s):  
Health Outcomes ◽  
Community Participation ◽  
General Health ◽  
Small Area ◽  
Positive Influence ◽  
Mixed Effects ◽  
Level Variation ◽  
Individual Level ◽  
Small Area Level ◽  
Informal Carers

Abstract Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with individual level variation in carers’ health outcomes.Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The sample consisted of 12,767 individuals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life.Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the individual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by individuals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.

scholarly journals Examining area-level variation in service organisation and delivery across the breadth of primary healthcare. Usefulness of measures constructed from routine data

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260615
Author(s):  
D. C. Butler ◽  
L. R. Jorm ◽  
S. Larkins ◽  
J. Humphreys ◽  
J. Desborough ◽  
...  
Keyword(s):  
Service Delivery ◽  
Primary Healthcare ◽  
Small Area ◽  
Cervical Screening ◽  
Preventative Care ◽  
Level Variation ◽  
After Hours Care ◽  
Service Organisation ◽  
Small Area Level ◽  
After Hours

Background Australia has a universal healthcare system, yet organisation and delivery of primary healthcare (PHC) services varies across local areas. Understanding the nature and extent of this variation is essential to improve quality of care and health equity, but this has been hampered by a lack of suitable measures across the breadth of effective PHC systems. Using a suite of measures constructed at the area-level, this study explored their application in assessing area-level variation in PHC organisation and delivery. Methods Routinely collected data from New South Wales, Australia were used to construct 13 small area-level measures of PHC service organisation and delivery that best approximated access (availability, affordability, accommodation) comprehensiveness and coordination. Regression analyses and pairwise Pearson’s correlations were used to examine variation by area, and by remoteness and area disadvantage. Results PHC service delivery varied geographically at the small-area level–within cities and more remote locations. Areas in major cities were more accessible (all measures), while in remote areas, services were more comprehensive and coordinated. In disadvantaged areas of major cities, there were fewer GPs (most disadvantaged quintile 0.9[SD 0.1] vs least 1.0[SD 0.2]), services were more affordable (97.4%[1.6] bulk-billed vs 75.7[11.3]), a greater proportion were after-hours (10.3%[3.0] vs 6.2[2.9]) and for chronic disease care (28%[3.4] vs 17.6[8.0]) but fewer for preventive care (50.7%[3.8] had cervical screening vs 62.5[4.9]). Patterns were similar in regional locations, other than disadvantaged areas had less after-hours care (1.3%[0.7] vs 6.1%[3.9]). Measures were positively correlated, except GP supply and affordability in major cities (-0.41, p < .01). Implications Application of constructed measures revealed inequity in PHC service delivery amenable to policy intervention. Initiatives should consider the maldistribution of GPs not only by remoteness but also by area disadvantage. Avenues for improvement in disadvantaged areas include preventative care across all regions and after-hours care in regional locations.

scholarly journals Spatial distribution of psychotic disorders in an urban area of France: an ecological study

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Baptiste Pignon ◽  
Franck Schürhoff ◽  
Grégoire Baudin ◽  
Aziz Ferchiou ◽  
Jean-Romain Richard ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Urban Area ◽  
Ecological Study ◽  
Psychotic Disorders

scholarly journals A Multilevel Mixed Effects Analysis of Informal Carers Health in Australia: The role of Community Participation, Social Support and Trust at Small Area level.

2020 ◽  
Author(s):  
Itismita Mohanty ◽  
Theo Niyonsenga ◽  
Tom Cochrane ◽  
Debra Rickwood
Keyword(s):  
Health Outcomes ◽  
Community Participation ◽  
General Health ◽  
Small Area ◽  
Positive Influence ◽  
Mixed Effects ◽  
Level Variation ◽  
Individual Level ◽  
Small Area Level ◽  
Informal Carers

Abstract Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with individual level variation in carers’ health outcomes.Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The sample consisted of 12,767 individuals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life.Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the individual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by individuals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.

Sign in / Sign up

Export Citation Format

Share Document