The association between perceived social support in adolescence and positive mental health outcomes in early adulthood: a prospective cohort study.

AIMS: The link between perceived social support and mental health has received much attention from numerous scientific fields in recent years. Most studies, however, have examined associations only over relatively short follow-up periods using global measures of perceived social support and dichotomous negative indicators of mental health. We investigated the long-term association between perceived social support from friends, parents and teachers and multiple positive hedonic and eudemonic indicators of mental health, including hope, meaningfulness and subjective well-being. METHODS: This study used questionnaire data from 2004, 2007 and 2010 from the West Jutland Birth Cohort study with linked register data. The study population consisted of 3681 adolescents born in 1989. Multiple linear and ordered logistic regression were used to analyse the association between perceived social support at age 14/15 years and mental health indicators at age 20/21 years while controlling for possible confounders, including the Big Five personality traits and baseline symptoms of depression. RESULTS: The results show that perceived social support from friends in adolescence was positively associated with all indicators of mental health in early adulthood. Furthermore, perceived paternal social support was positively associated with meaningfulness and subjective well-being, while perceived social support from teachers was positively associated with meaningfulness. CONCLUSIONS: Overall, the results from this study indicate that perceived social support in adolescence, particularly support from friends, could promote positive mental health outcomes in early adulthood.

Long-term association between neighbourhood socioeconomic deprivation in early childhood and perceived stress in early adulthood: a multilevel cohort study.

BACKGROUND: Previous studies have shown that neighbourhood socioeconomic deprivation is related to mental health problems, with chronic stress responses as one possible biopsychological pathway; however, less is known about the possible long-term effects of neighbourhood deprivation throughout the life course. The aim of this study was to examine the association between neighbourhood socioeconomic deprivation in early childhood and perceived stress in early adulthood. METHODS: Data from the, Danish National Health Survey 2017 in which Cohen's 10-item Perceived Stress Scale was measured (range 0-40) were used to follow a cohort consisting of all survey respondents aged 20-24 years born between 1992 and 1996. The respondents were linked to Danish register data, including data on the parent(s) with whom the respondents lived, to measure family-level socioeconomic characteristics, parental mental health problems and neighbourhood socioeconomic deprivation at age 3 for each respondent. Furthermore, the respondents were linked to georeferenced neighbourhoods. Linear mixed models were used to estimate the association between neighbourhood socioeconomic deprivation at age 3 and perceived stress at age 20-24. RESULTS: A 1 SD increase in neighbourhood socioeconomic deprivation in early childhood was associated with a 0.59-point increase in perceived stress in early adulthood (95% CI 0.41 to 0.77). The association was attenuated but remained statistically significant after controlling for individual and family characteristics and neighbourhood socioeconomic deprivation in early adulthood (coef 0.26, 95% CI 0.06 to 0.46). CONCLUSION: The findings suggest that children growing up in more socioeconomically deprived neighbourhoods may be prone to higher levels of perceived stress later in life.

Positive association between social capital and the quality of health care service: A cross-sectional study.

BACKGROUND: Social capital is an acknowledged theoretical concept in work environment research focusing on collective resources that arise from social networks between employees in the workplace. Social capital is divided into bonding (in the work unit), bridging (between work units), and linking social capital (between the work units and management). However, only a few studies have investigated the relationship between social capital and the quality of health care, which is the key outcome of hospital services. OBJECTIVE: We investigated the associations between bonding, bridging and two types of linking social capital with the self-reported quality of health care services among Danish hospital employees. Next, we directly compared how social capital, workload and work pace each affected the quality of health care. DESIGN: A cross-sectional study at Regional Hospital West Jutland, Denmark. DATA: Questionnaire data were collected from 1589 Danish hospital employees. We used validated scales for social capital, workload, and work pace and self-developed scales for clinical quality, quality of patient involvement, and overall professional quality. METHODS: Binary logistic regression analyses were conducted. RESULTS: The analyses showed significant, positive associations of bonding and bridging social capital with all types of quality and negative associations between workload and all types of quality. The work pace was negatively associated with clinical quality. When covariates were included in the model, the associations remained statistically significant and showed no decrease in odds ratios. The marginal effects showed that when bonding and bridging social capital were increased by a single scale point, the predicted probability for a high clinical quality increased by an average of 0.5 percentage points. This increase corresponds to a change in the predicted probability of self-reported high clinical quality from 10% for the lowest reported bridging social capital to 54% for the highest reported bridging social capital. For workload and work pace, the effects were -0.2 and -0.3 percentage points, respectively. DISCUSSION & CONCLUSIONS: This study adds to the literature on positive work environment factors by focusing on social capital and the importance of well-functioning relationships within and especially between hospital units for high-quality health care. Hence, bridging and bonding social capital should be included in theoretical frameworks, as well as in hospital strategies and work environment guidelines to potentially improve the quality of health care services. However, further studies are needed to develop and test the effects of specific social capital interventions on the quality of health care services.

Neighborhood social context and suicide mortality: A multilevel register-based 5-year follow-up study of 2.7 million individuals.

Previous studies have linked neighborhood social characteristics to suicide mortality. However, the effects of the operational definition of neighborhoods and the general importance of neighborhood context on suicide mortality have received little attention, with most studies using various administrative areas as neighborhood delineations. In this study, neighborhoods were delineated by micro-areas generated with an automated redistricting algorithm and divided by physical barriers, such as large roads. The geographic data were linked to register data on the Danish adult population in the age range of 20-59 years in December 2013 (N = 2,672,799 individuals nested into 7943 neighborhoods). This cohort was followed for five years to evaluate the association between suicide mortality and neighborhood socioeconomic deprivation, social fragmentation, and population density. We used the median hazard ratio (MHR) to quantify the general contextual effect (GCE) of neighborhoods on suicide mortality and hazard ratios to quantify the specific contextual effects (SCEs) using multilevel survival models stratified by age group. The results showed a larger GCE and larger SCEs of neighborhoods on suicide mortality for individuals aged 20-39 years compared with those aged 40-59 years. After controlling for individual characteristics, higher suicide mortality was observed for individuals living in the least densely populated neighborhoods and the most socially fragmented neighborhoods for both age groups. We found cross-level interactions between neighborhood population density and gender and ethnicity for those aged 40-59 years, as well as between neighborhood social fragmentation and ethnicity for those aged 20-39 years. The results indicate that beyond individual characteristics, the neighborhood social context may affect the risk of suicide, especially for people aged 20-39 years.

Opening the black box of the relationship between neighborhood socioeconomic status and mental health: Neighborhood social-interactive characteristics as contextual mechanisms.

Previous studies have linked low neighborhood socioeconomic status (NSES) to mental health problems. However, few studies have investigated the mechanisms underlying this association and most focused on the association with negative indicators of mental health, such as symptoms of depression or anxiety. This paper investigated whether neighborhood social characteristics (social interaction, trust, safety, organization participation, and attachment) mediate the association between NSES and mental health. We combined Danish register data with survey data from the North Denmark Region Health Survey 2017. Mental health was assessed with the Rand 12-item Short-form Survey (SF-12). The sample consisted of 14,969 individuals nested in 1047 neighborhoods created with an automated redistricting algorithm. We fitted multilevel structural equation mediation models and used a Monte Carlo simulation method to estimate confidence intervals for the indirect effects. NSES was positively associated with mental health. Neighborhood trust significantly mediated this relationship, accounting for 34% of the association after controlling for other mediators. These results indicate that higher levels of mental health in more affluent neighborhoods are partially explained by higher levels of trust. Improving neighborhood trust could mitigate sociogeographic inequalities in mental health.

Neighborhood socioeconomic deprivation and psychiatric medication purchases. Different neighborhood delineations, different results? A nationwide register-based multilevel study.

Previous studies of neighborhood socioeconomic deprivation and mental health treatment have shown mixed results. Multiple reviews have highlighted that the definition and measurement of neighborhoods can lead to different results, providing one explanation for these mixed findings. This study compares the use of micro-areas created using an automated redistricting algorithm and divided by physical barriers with the use of two administrative units, Danish parishes and postal codes. The geographical data are linked to Danish register data of the Danish population from age 16 in 2017, N = 4,347,001, to measure the association between the purchase of psychiatric medication and neighborhood socioeconomic deprivation using logistic multilevel models. Neighborhood socioeconomic deprivation is associated with a slightly increased probability of redeeming prescriptions for psychiatric medication after controlling for individual sociodemographic composition. However, this association was present only for micro-areas and not for parishes or postal codes. The results indicate that neighborhood effects on psychiatric medication purchases are affected by the neighborhood delineations used and that future studies should carefully consider how neighborhoods are defined and measured.