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Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data

Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Keith Lloyd Orcid Logo, Ian Jones, James T.R. Walters, Michael J. Owen, Michael O'Donovan, Ann John Orcid Logo

Schizophrenia Research, Volume: 220, Pages: 130 - 140

Swansea University Authors: Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Keith Lloyd Orcid Logo, Ann John Orcid Logo

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DOI (Published version): 10.1016/j.schres.2020.03.044

Abstract

We investigated whether associations between area deprivation, urbanicity and elevated risk of severe mental illnesses (SMIs, including schizophrenia and bipolar disorder) is accounted for by social drift or social causation. We extracted primary and secondary care electronic health records from 200...

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Published in: Schizophrenia Research
ISSN: 0920-9964
Published: Elsevier BV 2020
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URI: https://cronfa.swan.ac.uk/Record/cronfa53852
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We extracted primary and secondary care electronic health records from 2004 to 2015 from a population of 3.9 million. We identified prevalent and incident individuals with SMIs and their level of deprivation and urbanicity using the Welsh Index of Multiple Deprivation (WIMD) and urban/rural indicator. The presence of social drift was determined by whether odds ratios (ORs) from logistic regression is greater than the incidence rate ratios (IRRs) from Poisson regression. Additionally, we performed longitudinal analysis to measure the proportion of change in deprivation level and rural/urban residence 10 years after an incident diagnosis of SMI and compared it to the general population using standardised rate ratios (SRRs). Prevalence and incidence of SMIs were significantly associated with deprivation and urbanicity (all ORs and IRRs significantly &gt; 1). ORs and IRRs were similar across all conditions and cohorts (ranging from 1.1 to 1.4). Results from the longitudinal analysis showed individuals with SMIs are more likely to move compared to the general population. However, they did not preferentially move to more deprived or urban areas. There was little evidence of downward social drift over a 10-year period. 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spelling 2022-12-02T14:25:04.6200473 v2 53852 2020-03-23 Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data 10628af4988d624b49c4de7bd78b4694 Sze Chim Lee Sze Chim Lee true false f141785b1c0ab9efe45665d35c081b84 0000-0003-1502-389X Marcos del Pozo Banos Marcos del Pozo Banos true false a13aaa0df9045c205e82ed3b95d18c10 0000-0002-1440-4124 Keith Lloyd Keith Lloyd true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2020-03-23 FGMHL We investigated whether associations between area deprivation, urbanicity and elevated risk of severe mental illnesses (SMIs, including schizophrenia and bipolar disorder) is accounted for by social drift or social causation. We extracted primary and secondary care electronic health records from 2004 to 2015 from a population of 3.9 million. We identified prevalent and incident individuals with SMIs and their level of deprivation and urbanicity using the Welsh Index of Multiple Deprivation (WIMD) and urban/rural indicator. The presence of social drift was determined by whether odds ratios (ORs) from logistic regression is greater than the incidence rate ratios (IRRs) from Poisson regression. Additionally, we performed longitudinal analysis to measure the proportion of change in deprivation level and rural/urban residence 10 years after an incident diagnosis of SMI and compared it to the general population using standardised rate ratios (SRRs). Prevalence and incidence of SMIs were significantly associated with deprivation and urbanicity (all ORs and IRRs significantly > 1). ORs and IRRs were similar across all conditions and cohorts (ranging from 1.1 to 1.4). Results from the longitudinal analysis showed individuals with SMIs are more likely to move compared to the general population. However, they did not preferentially move to more deprived or urban areas. There was little evidence of downward social drift over a 10-year period. These findings have implications for the allocation of resources, service configuration and access to services in deprived communities, as well as, for broader public health interventions addressing poverty, and social and environmental contexts. Journal Article Schizophrenia Research 220 130 140 Elsevier BV 0920-9964 bipolar disorder, deprivation, schizophrenia, severe mental illness, social drift, urbanicity 1 6 2020 2020-06-01 10.1016/j.schres.2020.03.044 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2022-12-02T14:25:04.6200473 2020-03-23T14:38:21.7052705 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Sze Chim Lee 1 Marcos del Pozo Banos 0000-0003-1502-389X 2 Keith Lloyd 0000-0002-1440-4124 3 Ian Jones 4 James T.R. Walters 5 Michael J. Owen 6 Michael O'Donovan 7 Ann John 0000-0002-5657-6995 8 53852__17654__87bae10277e04ff487c64375c4bab407.pdf 53852.pdf 2020-07-07T06:27:38.1208244 Output 1817421 application/pdf Version of Record true This is an open access article under the CC-BY-NC-ND license. true eng https://creativecommons.org/licenses/by-nc-nd/4.0/
title Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data
spellingShingle Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data
Sze Chim Lee
Marcos del Pozo Banos
Keith Lloyd
Ann John
title_short Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data
title_full Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data
title_fullStr Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data
title_full_unstemmed Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data
title_sort Area deprivation, urbanicity, severe mental illness and social drift — A population-based linkage study using routinely collected primary and secondary care data
author_id_str_mv 10628af4988d624b49c4de7bd78b4694
f141785b1c0ab9efe45665d35c081b84
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author_id_fullname_str_mv 10628af4988d624b49c4de7bd78b4694_***_Sze Chim Lee
f141785b1c0ab9efe45665d35c081b84_***_Marcos del Pozo Banos
a13aaa0df9045c205e82ed3b95d18c10_***_Keith Lloyd
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Sze Chim Lee
Marcos del Pozo Banos
Keith Lloyd
Ann John
author2 Sze Chim Lee
Marcos del Pozo Banos
Keith Lloyd
Ian Jones
James T.R. Walters
Michael J. Owen
Michael O'Donovan
Ann John
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container_title Schizophrenia Research
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publishDate 2020
institution Swansea University
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doi_str_mv 10.1016/j.schres.2020.03.044
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
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hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description We investigated whether associations between area deprivation, urbanicity and elevated risk of severe mental illnesses (SMIs, including schizophrenia and bipolar disorder) is accounted for by social drift or social causation. We extracted primary and secondary care electronic health records from 2004 to 2015 from a population of 3.9 million. We identified prevalent and incident individuals with SMIs and their level of deprivation and urbanicity using the Welsh Index of Multiple Deprivation (WIMD) and urban/rural indicator. The presence of social drift was determined by whether odds ratios (ORs) from logistic regression is greater than the incidence rate ratios (IRRs) from Poisson regression. Additionally, we performed longitudinal analysis to measure the proportion of change in deprivation level and rural/urban residence 10 years after an incident diagnosis of SMI and compared it to the general population using standardised rate ratios (SRRs). Prevalence and incidence of SMIs were significantly associated with deprivation and urbanicity (all ORs and IRRs significantly > 1). ORs and IRRs were similar across all conditions and cohorts (ranging from 1.1 to 1.4). Results from the longitudinal analysis showed individuals with SMIs are more likely to move compared to the general population. However, they did not preferentially move to more deprived or urban areas. There was little evidence of downward social drift over a 10-year period. These findings have implications for the allocation of resources, service configuration and access to services in deprived communities, as well as, for broader public health interventions addressing poverty, and social and environmental contexts.
published_date 2020-06-01T04:07:02Z
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