Mental health in the slums of Dhaka - a geoepidemiological study

Gruebner O, Khan MH, Lautenbach S, et al. Mental health in the slums of Dhaka - a geoepidemiological study. BMC Public Health. 2012;12(1): 177.Background: Urban health is of global concern because the majority of the world's population lives in urban areas. Although mental health problems (e.g. depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum of mental well-being in urban slums and only poor knowledge exists on health promotive socio-physical environments in these areas. Using a geo-epidemiological approach, the present study identified factors that contribute to the mental well-being in the slums of Dhaka, which currently accommodates an estimated population of more than 14 million, including 3.4 million slum dwellers. Methods: The baseline data of a cohort study conducted in early 2009 in nine slums of Dhaka were used. Data were collected from 1,938 adults (>= 15 years). All respondents were geographically marked based on their households using global positioning systems (GPS). Very high-resolution land cover information was processed in a Geographic Information System (GIS) to obtain additional exposure information. We used a factor analysis to reduce the socio-physical explanatory variables to a fewer set of uncorrelated linear combinations of variables. We then regressed these factors on the WHO-5 Well-being Index that was used as a proxy for self-rated mental wellbeing. Results: Mental well-being was significantly associated with various factors such as selected features of the natural environment, flood risk, sanitation, housing quality, sufficiency and durability. We further identified associations with population density, job satisfaction, and income generation while controlling for individual factors such as age, gender, and diseases. Conclusions: Factors determining mental well-being were related to the socio-physical environment and individual level characteristics. Given that mental well-being is associated with physiological well-being, our study may provide crucial information for developing better health care and disease prevention programmes in slums of Dhaka and other comparable settings

Mental Health and Recovery in the Urban Setting: Brescia and the San Polo District

Urban settings have been historically associated with an increase ofmental illness, in contrast with more rural environments. Also the de-institutionalisation of mental healthcare has seen the coming-back to town of former psychiatric hospital inpatients, initiating other forms of seclusion associated with stigma and self-stigma and stimulating the activation of several community-based initiatives. This chapter reviews the city-mental health relationship, introducing the specific case of Brescia in Italy, and the work of a operative unity for psychiatry—UOP23—leading a transformational project in the San Polo district

Space-Time Dependence of Emotions on Twitter after a Natural Disaster

Natural disasters can have significant consequences for population mental health. Using a digital spatial epidemiologic approach, this study documents emotional changes over space and time in the context of a large-scale disaster. Our aims were to (a) explore the spatial distribution of negative emotional expressions of Twitter users before, during, and after Superstorm Sandy in New York City (NYC) in 2012 and (b) examine potential correlations between socioeconomic status and infrastructural damage with negative emotional expressions across NYC census tracts over time. A total of 984,311 geo-referenced tweets with negative basic emotions (anger, disgust, fear, sadness, shame) were collected and assigned to the census tracts within NYC boroughs between 8 October and 18 November 2012. Global and local univariate and bivariate Moran’s I statistics were used to analyze the data. We found local spatial clusters of all negative emotions over all disaster periods. Socioeconomic status and infrastructural damage were predominantly correlated with disgust, fear, and shame post-disaster. We identified spatial clusters of emotional reactions during and in the aftermath of a large-scale disaster that could help provide guidance about where immediate and long-term relief measures are needed the most, if transferred to similar events and on comparable data worldwide

Public health interventions, epidemic growth, and regional variation of the 1918 influenza pandemic outbreak in a Swiss canton and its greater regions

Public health interventions implemented during the coronavirus disease 2019 (COVID-19) pandemic are based on experience gained from past pandemics. The 1918 influenza pandemic is the most extensively researched historical influenza outbreak. All 9335 reports available in the State Archives on 121 152 cases of influenza-like illness from the canton of Bern from 473 of 497 municipalities (95.2%) were collected; the cases were registered between 30 June 1918 and 30 June 1919. The overall incidence rates of newly registered cases per week for the 9 greater regions of Bern for both the first and second waves of the pandemic were calculated. Relative incidence rate ratios (RIRRs) were calculated to estimate the change in the slope of incidence curves associated with public health interventions. During the first wave, school closures (RIRR, 0.16 [95% CI, 0.15 to 0.17]) and restrictions of mass gatherings (RIRR, 0.57 [CI, 0.54 to 0.61]) were associated with a deceleration of epidemic growth. During the second wave, in autumn 1918, cantonal authorities initially reacted hesitantly and delegated the responsibility to enact interventions to municipal authorities, which was associated with a lack of containment of the second wave. A premature relaxation of restrictions on mass gatherings was associated with a resurgence of the epidemic (RIRR, 1.18 [CI, 1.12 to 1.25]). Strikingly similar patterns were found in the management of the COVID-19 outbreak in Switzerland, with a considerably higher amplitude and prolonged duration of the second wave and much higher associated rates of hospitalization and mortality

Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike

We investigated geographic concentration in elevated risk for a range of postdisaster trajectories of chronic posttraumatic stress symptom (PTSS) and depression symptoms in a longitudinal study (N = 561) of a Hurricane Ike affected population in Galveston and Chambers counties, TX. Using an unadjusted spatial scan statistic, we detected clusters of elevated risk of PTSS trajectories, but not depression trajectories, on Galveston Island. We then tested for predictors of membership in each trajectory of PTSS and depression (e.g., demographic variables, trauma exposure, social support), not taking the geographic nature of the data into account. After adjusting for significant predictors in the spatial scan statistic, we noted that spatial clusters of PTSS persisted and additional clusters of depression trajectories emerged. This is the first study to show that longitudinal trajectories of postdisaster mental health problems may vary depending on the geographic location and the individual- and community-level factors present at these locations. Such knowledge is crucial to identifying vulnerable regions and populations within them, to provide guidance for early responders, and to mitigate mental health consequences through early detection of mental health needs in the population. As human-made disasters increase, our approach may be useful also in other regions in comparable settings worldwide