Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design, Population, and Sample
2.2. Variables
2.3. Methods of Analysis
- -
- Calculation of the frequencies that would have been observed in the 2010 sample in every stratum, in case the percentage distribution observed in 2005 would have not changed:
- = Frequency in stratum i in 2005;
- = Frequency in stratum i in 2010;
- = Frequency that should have been observed in stratum i in 2010 if percentage distribution would have changed as regards 2005.
- -
- Calculation of the observed GHQ+ prevalence in 2010, in every disaggregation stratum:
- = Number of GHQ+ cases observed in the stratum i in 2010;
- = Prevalence of GHQ+ in the stratum i in 2010.
- -
- Calculation of expected cases of mental health and its prevalence in every stratum:
- = Number of expected cases of GHQ+ in the stratum i in 2010 if percentage distribution would not have changed as regards 2005;
- = Expected prevalence in the stratum i in 2010 if percentage distribution would not have changed as regards 2005.
- -
- Finally, the overall expected prevalence in 2010 was calculated if the percentage distribution with respect to 2005, disaggregated by sex, had not been changed, adding all previous cells, as follows:
3. Results
3.1. Risk of Poor Mental Health and Associated Variables
3.2. Impact of the Crisis and Changes in Prevalence
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
VC | Valencian Community |
ESCV | Health Survey of Valencian Community |
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MEN | 2005 | 2010 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | 95%CI | Po | 95%CI | p * | n | % | 95%CI | Prev | 95%CI | p * | ||
Total | 2846 | 100 | ------ | 16.2 | (14.8–17.6) | ------ | 1702 | 100 | ------ | 25.4 | (23.3–27.5) | ------ | |
Age | 16–44 | 1588 | 55.8 | (53.4–58.2) | 13.5 | (8.9–18.1) | <0.001 | 919 | 54.0 | (50.8–57.2) | 25.4 | (19.8–30.9) | 0.104 |
45–64 | 787 | 27.7 | (24.5–30.8) | 16.8 | (10.4–23.1) | 497 | 29.2 | (25.2–33.2) | 25.2 | (17.5–32.8) | |||
65–84 | 438 | 15.4 | (12.0–18.8) | 21.9 | (13.6–30.2) | 257 | 15.1 | (10.7–19.5) | 23.7 | (13.1–34.4) | |||
≥85 | 33 | 1.2 | (0.0–4.8) | 54.5 | (31.5–77.5) | 29 | 1.7 | (0.0–6.4) | 44.8 | (17.8–71.9) | |||
Country of birth | Spain | 2420 | 89.9 | (88.7–91.1) | 16.4 | (12.7–20.0) | 0.562 | 1460 | 85.7 | (83.9–87.5) | 24.2 | (19.7–28.6) | 0.007 |
Abroad | 273 | 10.1 | (6.6–13.7) | 16.1 | (5.3–27.0) | 243 | 14.3 | (9.9–18.7) | 32.5 | (22.2–42.8) | |||
Chronic disease | No | 1739 | 61.1 | (58.8–63.4) | 10.0 | (5.5–14.5) | <0.001 | 1039 | 61.0 | (58.1–64.0) | 20.9 | (15.5–26.3) | <0.001 |
Yes | 1107 | 38.9 | (36.0–41.8) | 25.8 | (20.8–30.9) | 663 | 39.0 | (35.2–42.7) | 32.4 | (26.2–38.7) | |||
Disability | No | 2459 | 86.4 | (85.1–87.8) | 12.5 | (8.8–16.2) | <0.001 | 1369 | 80.4 | (78.3–82.5) | 10.4 | (5.4–15.4) | <0.001 |
Yes | 386 | 13.6 | (10.2–17.0) | 39.1 | (31.3–46.9) | 334 | 19.6 | (15.4–23.9) | 86.2 | (82.2–90.2) | |||
Level of studies | University | 413 | 14.7 | (11.3–18.1) | 10.9 | (1.8–20.0) | <0.001 | 316 | 18.6 | (14.3–22.9) | 20.9 | (11.1–30.7) | 0.064 |
Prof. train/high school | 675 | 24.0 | (20.8–27.3) | 12.6 | (5.5–19.6) | 745 | 43.8 | (40.2–47.4) | 24.6 | (18.3–30.8) | |||
Elementary school | 1698 | 60.4 | (58.1–62.8) | 18.4 | (14.1–22.7) | 493 | 29.0 | (25.0–33.0) | 27.8 | (20.3–35.3) | |||
No qualifications | 23 | 0.8 | (0.0–4.5) | 47.8 | (18.3–77.3) | 147 | 8.6 | (4.1–13.2) | 30.6 | (17.1–44.1) | |||
Employment | Employed | 1866 | 66.1 | (64.0–68.3) | 11.5 | (10.1–12.9) | <0.001 | 878 | 51.6 | (48.3–54.9) | 20.2 | (17.5–22.9) | <0.001 |
situation | Unemployed | 128 | 4.5 | (0.9–8.1) | 34.4 | (26.2–42.6) | 279 | 16.4 | (12.1–20.7) | 37.3 | (31.6–43.0) | ||
Other | 827 | 29.3 | (26.2–32.4) | 23.8 | (20.9–26.7) | 544 | 32.0 | (28.1–35.9) | 27.6 | (23.8–31.4) | |||
Income level | Medium–high | 1757 | 68.7 | (66.5–70.9) | 12.6 | (11.0–14.2) | <0.001 | 861 | 56.6 | (53.3–59.9) | 16.4 | (13.9–18.9) | <0.001 |
Low | 800 | 31.3 | (28.1–34.5) | 23.5 | (20.6–26.4) | 660 | 43.4 | (39.6–47.2) | 33.5 | (29.9–37.1) | |||
Occupation | Nonmanual work | 1184 | 62.1 | (59.3–64.8) | 13.8 | (8.5–19.1) | 0.076 | 518 | 36.8 | (32.7–41.0) | 18.5 | (10.8–26.3) | <0.001 |
Manual work | 724 | 37.9 | (34.4–41.5) | 10.9 | (4.0–17.8) | 889 | 63.2 | (60.0–66.4) | 29.1 | (23.6–34.7) | |||
Marital status | Single | 989 | 34.8 | (31.9–37.8) | 14.9 | (9.1–20.6) | <0.001 | 557 | 32.7 | (28.8–36.6) | 24.6 | (17.4–31.8) | <0.001 |
Married | 1668 | 58.7 | (56.4–61.1) | 15.6 | (11.2–20.1) | 1045 | 61.4 | (58.4–64.4) | 23.6 | (18.3–28.9) | |||
divorced/separated | 116 | 4.1 | (0.5–7.7) | 25.0 | (9.2–40.8) | 56 | 3.3 | (0.0–8.0) | 51.8 | (33.6–70.0) | |||
Widower | 67 | 2.4 | (0.0–6.0) | 32.8 | (13.2–52.5) | 44 | 2.6 | (0.0–7.3) | 43.2 | (20.9–65.5) | |||
Living with a | Yes | 1750 | 61.7 | (59.4–64.0) | 15.5 | (11.2–19.8) | 0.464 | 961 | 56.5 | (53.3–59.6) | 22.5 | (16.9–28.0) | 0.002 |
partner | No | 1087 | 38.3 | (35.4–41.2) | 17.2 | (11.8–22.6) | 741 | 43.5 | (40.0–47.1) | 29.1 | (23.1–35.2) | ||
Social support | Good support | 2636 | 93.5 | (92.5–94.4) | 14.0 | (10.5–17.6) | <0.001 | 1639 | 96.2 | (95.3–97.2) | 24.1 | (19.9–28.3) | <0.001 |
Bad support | 184 | 6.5 | (3.0–10.1) | 46.2 | (35.6–56.8) | 64 | 3.8 | (0.0–8.4) | 57.8 | (41.9–73.7) |
WOMEN | 2005 | 2010 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | 95%CI | Po | 95%CI | p * | n | % | 95%CI | Po | 95%CI | p * | ||
Total | 2905 | 100 | ------ | 24.0 | (22.4–25.6) | ------ | 1777 | 100 | ------ | 30.6 | (28.5–32.7) | ------ | |
Age | 16–44 | 1479 | 50.9 | (48.4–53.5) | 19.7 | (15.2–24.3) | <0.001 | 867 | 48.8 | (45.5–52.1) | 28.0 | (22.4–33.7) | 0.001 |
45–64 | 814 | 28.0 | (24.9–31.1) | 26.7 | (20.8–32.5) | 524 | 29.5 | (25.6–33.4) | 31.1 | (24.0–38.2) | |||
65–84 | 542 | 18.7 | (15.4–21.9) | 29.7 | (22.6–36.8) | 326 | 18.3 | (14.1–22.5) | 32.5 | (23.6–41.4) | |||
≥85 | 70 | 2.4 | (0.0–6.0) | 32.9 | (13.7–52.1) | 60 | 3.4 | (–1.2 to 7.9) | 51.7 | (34.1–69.3) | |||
Country | Spain | 2452 | 89.6 | (8.4–90.8) | 23.9 | (20.5–27.4) | <0.001 | 1557 | 87.6 | (86.0–89.3) | 29.1 | (24.9–33.3) | 0.001 |
of birth | Abroad | 284 | 10.4 | (6.8–13.9) | 21.5 | (11.2–31.8) | 220 | 12.4 | (8.0–16.7) | 40.9 | (30.8–51.1) | ||
Chronic | No | 1412 | 48.6 | (46.0–51.2) | 14.2 | (9.4–19.1) | <0.001 | 980 | 55.1 | (52.0–58.3) | 25.2 | (19.8–30.6) | <0.001 |
Disease | yes | 1493 | 51.4 | (48.9–53.9) | 33.0 | (28.8–37.1) | 797 | 44.9 | (41.4–48.3) | 37.1 | (31.6–42.6) | ||
Disability | No | 2450 | 84.3 | (82.9–85.8) | 19.8 | (16.3–23.4) | <0.001 | 1271 | 71.8 | (69.4–74.3) | 23.8 | (19.0–28.6) | <0.001 |
Yes | 455 | 15.7 | (12.3–19.0) | 45.7 | (38.9–52.5) | 498 | 28.2 | (24.2–32.1) | 48.2 | (41.9–54.5) | |||
Level of studies | University | 451 | 15.7 | (12.4–19.1) | 17.5 | (9.1–25.9) | <0.001 | 310 | 17.5 | (13.2–21.7) | 24.8 | (15.2–34.5) | <0.001 |
Prof. train/high school | 598 | 20.8 | (17.6–24.1) | 20.7 | (13.6–27.9) | 738 | 41.6 | (38.0–45.1) | 26.4 | (20.2–32.6) | |||
Elementary school | 1750 | 61.0 | (58.7–63.3) | 26.1 | (22.0–30.1) | 505 | 28.4 | (24.5–32.4) | 37.0 | (30.1–44.0) | |||
No qualifications | 70 | 2.4 | (0.0–6.1) | 37.1 | (18.6–55.7) | 223 | 12.6 | (8.2–16.9) | 37.2 | (26.8–47.6) | |||
Employment | Employed | 1106 | 38.4 | (35.5–41.3) | 19.1 | (13.8–24.4) | <0.001 | 721 | 40.5 | (36.9–44.1) | 24.8 | (18.5–31.2) | <0.001 |
situation | Unemployed | 178 | 6.2 | (2.6–9.7) | 27.5 | (15.0–40.0) | 222 | 12.5 | (8.1–16.8) | 44.1 | (34.3–54.0) | ||
Other | 1594 | 55.4 | (53.0–57.8) | 27.1 | (24.9–29.3) | 836 | 47.0 | (43.6–50.4) | 31.9 | (28.7–35.1) | |||
Income level | Medium–high | 1705 | 65.2 | (62.9–67.5) | 19.3 | (17.4–21.2) | <0.001 | 886 | 55.9 | (52.6–59.2) | 22.3 | (19.6–25.0) | <0.001 |
Low | 908 | 34.8 | (31.7–37.9) | 33.6 | (30.5–36.7) | 699 | 44.1 | (40.4–47.8) | 38.5 | (34.9–42.1) | |||
Occupation | Nonmanual work | 1020 | 61.2 | (58.2–64.2) | 22.2 | (16.7–27.6) | 0.072 | 452 | 41.9 | (37.3–46.4) | 25.7 | (17.7–33.6) | 0.009 |
Manual work | 646 | 38.8 | (35.0–42.5) | 18.4 | (11.5–25.4) | 628 | 58.1 | (54.3–62.0) | 33.1 | (26.7–39.5) | |||
Marital status | Single | 792 | 27.3 | (24.2–30.4) | 21.2 | (15.0–27.4) | <0.001 | 422 | 23.7 | (19.7–27.8) | 28.9 | (20.9–37.0) | 0.023 |
Married | 1666 | 57.4 | (55.1–59.8) | 22.7 | (18.5–27.0) | 1051 | 59.1 | (56.2–62.1) | 29.8 | (24.7–34.8) | |||
Divorced/separated | 130 | 4.5 | (0.9–8.0) | 32.3 | (18.2–46.5) | 106 | 6.0 | (1.5–10.5) | 27.4 | (11.1–43.6) | |||
Widower | 312 | 10.8 | (7.3–14.2) | 33.0 | (23.9–42.1) | 198 | 11.1 | (6.8–15.5) | 39.9 | (29.1–50.7) | |||
Living with a | Yes | 1729 | 59.7 | (57.4–62.1) | 22.4 | (18.3–26.6) | 0.039 | 970 | 54.6 | (51.5–57.7) | 29.0 | (23.7–34.3) | 0.121 |
partner | No | 1165 | 40.3 | (37.4–43.1) | 25.8 | (20.9–30.8) | 807 | 45.4 | (42.0–48.8) | 32.5 | (26.8–38.1) | ||
Social support | Good support | 2643 | 91.6 | (90.5–92.6) | 21.0 | (17.6–24.4) | <0.001 | 1719 | 96.8 | (96.0–97.6) | 29.5 | (25.5–33.5) | <0.001 |
Bad support | 243 | 8.4 | (4.9–11.9) | 54.7 | (46.3–63.2) | 57 | 3.2 | (0.0–7.8) | 63.2 | (47.4–78.9) |
MEN | 2005 | 2010 | |||||||
---|---|---|---|---|---|---|---|---|---|
n | Average | 95%CI | p * | n | Average | 95%CI | p * | ||
Num. chronic diseases | GHQ− | 2386 | 0.65 | (0.60–0.69) | <0.001 | 1270 | 0.78 | (0.71–0.86) | <0.001 |
GHQ+ | 460 | 1.71 | (1.52–1.90) | 432 | 1.59 | (1.37–1.80) | |||
EUROQoL quality of life | GHQ− | 2386 | 0.93 | (0.92–0.93) | <0.001 | 1270 | 0.92 | (0.91–0.93) | <0.001 |
GHQ+ | 460 | 0.73 | (0.70–0.75) | 432 | 0.78 | (0.75–0.80) | |||
WOMEN | |||||||||
Num. chronic diseases | GHQ− | 2212 | 0.93 | (0.87–0.99) | <0.001 | 1234 | 1.18 | (1.07–1.28) | <0.001 |
GHQ+ | 694 | 2.43 | (2.25–2.60) | 543 | 2.27 | (2.03–2.52) | |||
EUROQoL quality of life | GHQ− | 2212 | 0.89 | (0.88–0.90) | <0.001 | 1234 | 0.87 | (0.86–0.88) | <0.001 |
GHQ+ | 694 | 0.68 | (0.66–0.70) | 543 | 0.70 | (0.67–0.72) |
2005 | 2010 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Simple Analysis | Adjusted Analysis | Simple Analysis | Adjusted Analysis | |||||||||
OR | 95%CI | p ** | OR | 95%CI | p ** | OR | 95%CI | p ** | OR | 95%CI | p ** | |
Age | ||||||||||||
16–44 | 1 | 1 | 1 | 1 | ||||||||
45–64 | 1.4 | (1.2–1.6) | <0.001 | 0.8 | (0.7–1.0) | 0.082 | 1.1 | (0.9–1.3) | 0.337 | 0.8 | (0.6–0.9) | 0.010 |
65–84 | 1.8 | (1.5–2.1) | <0.001 | 0.4 | (0.3–0.6) | <0.001 | 1.1 | (0.9–1.4) | 0.297 | 0.4 | (0.3–0.6) | <0.001 |
≥85 | 3.5 | (2.3–5.2) | <0.001 | 0.5 | (0.3–0.9) | 0.026 | 2.6 | (1.7–4.1) | <0.001 | 0.4 | (0.2–0.7) | 0.003 |
Sex | ||||||||||||
Man | 1 | 1 | 1 | 1 | ||||||||
Woman | 1.6 | (1.4–1.8) | <0.001 | 1.2 | (1.0–1.4) | 0.020 | 1.3 | (1.1–1.5) | 0.001 | 1.1 | (0.9–1.3) | 0.225 |
Country of birth | ||||||||||||
Spain | 1 | 1 | 1 | 1 | ||||||||
Abroad | 0.9 | (0.7–1.1) | 0.441 | 1.0 | (0.8–1.4) | 0.743 | 1.6 | (1.3–1.9) | <0.001 | 1.6 | (1.2–2.0) | <0.001 |
Num. nonmental chronic diseases | 1.55 | (1.49–1.61) | <0.001 | 1.26 | (1.19–1.32) | <0.001 | 1.24 | (1.20–1.29) | <0.001 | 1.08 | (1.0–1.1) | 0.003 |
EuroQoL score | 0.02 | (0.01–0.03) | <0.001 | 0.04 | (0.03–0.07) | <0.001 | 0.04 | (0.03–0.06) | <0.001 | 0.05 | (0.03–0.10) | <0.001 |
Disability | ||||||||||||
No | 1 | 1 | 1 | 1 | ||||||||
Yes | 3.8 | (3.2–4.4) | <0.001 | 1.2 | (0.9–1.5) | 0.121 | 2.9 | (2.5–3.4) | <0.001 | 1.3 | (1.1–1.7) | 0.014 |
Social support | ||||||||||||
Good | 1 | 1 | 1 | 1 | ||||||||
Bad | 5.1 | (4.1–6.2) | <0.001 | 3.4 | (2.7–4.4) | <0.001 | 4.2 | (2.9–6.2) | <0.001 | 2.3 | (1.5–3.5) | <0.001 |
Living with a partner | ||||||||||||
Yes | 1 | 1 | 1 | 1 | ||||||||
No | 1.2 | (1.0–1.3) | 0.015 | 1.2 | (1.0–1.4) | 0.061 | 1.3 | (1.1–1.5) | 0.001 | 1.1 | (0.9–1.3) | 0.281 |
Employment Situation | ||||||||||||
Employed | 1 | 1 | 1 | 1 | ||||||||
Unemployed | 2.6 | (2.0–3.4) | <0.001 | 2.1 | (1.6–2.8) | <0.001 | 2.4 | (1.9–2.9) | <0.001 | 1.8 | (1.5–2.3) | <0.001 |
Other | 2.1 | (1.8–2.4) | <0.001 | 1.3 | (1.0–1.5) | 0.017 | 1.5 | (1.3–1.8) | <0.001 | 1.0 | (0.8–1.2) | 0.981 |
Income level | ||||||||||||
Medium–high | 1 | 1 | 1 | 1 | ||||||||
Low | 2.1 | (1.8–2.4) | <0.001 | 1.3 | (1.1–1.5) | 0.007 | 2.3 | (1.9–2.7) | <0.001 | 1.6 | (1.3–1.9) | <0.001 |
MEN | WOMEN | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
2005 | 2010 | 2005 | 2010 | |||||||||
%Pop | Po | % Pop | Po | Pe | Po–Pe | %Pop | Po | % Pop | Po | Pe | Po–Pe | |
Total | 100.0 | 16.2 | 100.0 | 25.4 | 21.4 | 4.0 | 100.0 | 24.0 | 100.0 | 30.6 | 28.5 | 2.1 |
Age | ||||||||||||
16–44 | 55.8 | 13.5 | 54.0 | 25.4 | 21.8 | 3.6 | 50.9 | 19.7 | 48.8 | 28.1 | 25.4 | 2.7 |
45–64 | 27.7 | 16.8 | 29.2 | 25.2 | 18.8 | 6.4 | 28.0 | 26.7 | 29.5 | 31.1 | 29.1 | 2.0 |
65+ | 16.6 | 24.2 | 16.8 | 25.8 | 24.5 | 1.3 | 21.1 | 30.1 | 21.7 | 35.5 | 35.2 | 0.3 |
Country of birth | ||||||||||||
Spain | 89.9 | 16.4 | 85.7 | 24.2 | 20.9 | 3.3 | 89.6 | 23.9 | 87.6 | 29.1 | 27.5 | 1.6 |
Abroad | 10.1 | 16.1 | 14.3 | 32.5 | 26.0 | 6.5 | 10.4 | 21.5 | 12.4 | 40.9 | 37.7 | 3.2 |
Income | ||||||||||||
Medium–high | 68.7 | 12.6 | 56.6 | 16.4 | 15.6 | 0.8 | 65.2 | 19.3 | 55.9 | 22.3 | 22.9 | -0.6 |
low | 31.3 | 23.5 | 43.4 | 33.5 | 30.0 | 3.5 | 34.8 | 33.6 | 44.1 | 38.5 | 35.6 | 2.9 |
Employment situation | ||||||||||||
Employed | 66.1 | 11.5 | 51.6 | 20.2 | 19.3 | 0.9 | 38.4 | 19.1 | 40.5 | 24.8 | 23.8 | 1.0 |
Unemployed | 4.5 | 34.4 | 16.4 | 37.3 | 34.3 | 3.0 | 6.2 | 27.5 | 12.5 | 44.1 | 39.1 | 5.0 |
Other | 29.3 | 23.8 | 32.0 | 27.6 | 24.2 | 3.4 | 55.4 | 27.1 | 47.0 | 31.9 | 30.6 | 1.3 |
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Tamayo-Fonseca, N.; Nolasco, A.; Moncho, J.; Barona, C.; Irles, M.Á.; Más, R.; Girón, M.; Gómez-Beneyto, M.; Pereyra-Zamora, P. Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain. Int. J. Environ. Res. Public Health 2018, 15, 2517. https://doi.org/10.3390/ijerph15112517
Tamayo-Fonseca N, Nolasco A, Moncho J, Barona C, Irles MÁ, Más R, Girón M, Gómez-Beneyto M, Pereyra-Zamora P. Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain. International Journal of Environmental Research and Public Health. 2018; 15(11):2517. https://doi.org/10.3390/ijerph15112517
Chicago/Turabian StyleTamayo-Fonseca, Nayara, Andreu Nolasco, Joaquín Moncho, Carmen Barona, María Ángeles Irles, Rosa Más, Manuel Girón, Manuel Gómez-Beneyto, and Pamela Pereyra-Zamora. 2018. "Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain" International Journal of Environmental Research and Public Health 15, no. 11: 2517. https://doi.org/10.3390/ijerph15112517
APA StyleTamayo-Fonseca, N., Nolasco, A., Moncho, J., Barona, C., Irles, M. Á., Más, R., Girón, M., Gómez-Beneyto, M., & Pereyra-Zamora, P. (2018). Contribution of the Economic Crisis to the Risk Increase of Poor Mental Health in a Region of Spain. International Journal of Environmental Research and Public Health, 15(11), 2517. https://doi.org/10.3390/ijerph15112517