Neighbourhood socioeconomic indicators and depressive symptoms in the Czech Republic: a population based study.

Pikhartova, Jitka; Chandola, Tarani; Kubinova, Ruzena; Bobak, Martin; Nicholson, Amanda; Pikhart, Hynek

OBJECTIVES Previous research shows only limited evidence on the contextual (neighbourhood-based) socioeconomic influences on mental health and depression. We investigated the association between individual and neighbourhood socioeconomic characteristics and depressive symptoms in the Czech Republic. METHODS Dichotomized CESD score of depressive symptoms was used as the outcome in a random sample of 3534 men and 4082 women aged 45-69 years in the Czech HAPIEE Study. 220 small areas were characterized by the proportion of university educated persons and the proportion of unemployed from the economically active population in the 2001 Census. Multilevel logistic regression was used for the analysis. RESULTS After controlling for individual-level variables, the effects of area-based characteristics were largely eliminated. The strongest area-based effect was that of the proportion of university educated persons; the ORs for 2(nd), 3(rd) and 4(th) quartile, compared with the 1(st) quartile, were 1.02, 0.93, and 0.82, respectively (p-value for trend 0.06). There were no cross-level interactions between socioeconomic variables. CONCLUSIONS The effects of neighbourhood characteristics in this study were largely explained by individual socioeconomic variables.