Abstract
Purpose
Urbanization is linked to increased health risks, including mental health. However, the large majority of this research has been conducted in high-income countries, and little is known about effects in low-and-middle-income countries (LMIC) where urbanization is occurring most frequently and most rapidly. Within global mental health, children and adolescents are a critical but understudied population. The present study assessed relations between urbanization factors, and child mental health in Vietnam, a Southeast Asian LMIC.
Methods
Most studies investigating urbanization and mental health have used geographically based dichotomous urban vs. rural variables. Because of significant limitations with this approach, the present study assessed parent-reported urbanization factors (e.g., pollution, crime). In Sub-study #1 (cross-sectional), 1314 parents from 10 Vietnam provinces completed the Urbanization Factors Questionnaire, Child Behavior Checklist (mental health), and Brief Impairment Scale (life functioning). In Sub-study #2 (longitudinal), 256 parents from one highly urban and one highly rural province completed the same measures, at three timepoints across 12 months.
Results
Cross-sectional canonical correlations identified relatively small (e.g., R2 = 0.08) but significant relations between urbanization factors, and child functioning. Parallel analyses using a geographically defined urban vs. rural variable did not produce significant results. The large majority of longitudinal relations between the different urbanization factors and child functioning were non-significant.
Conclusions
This study, among the first to assess urbanization as a multi-dimensional continuous construct in relation to child psychopathology, highlights the value of the use of an urbanization factors approach. A new “urbanization factors differentials” theory is proposed to suggest how effects of urbanization factors might result in global health disparities.
Similar content being viewed by others
References
Erfe JM, Choe JK (2014) Introduction: the global health movement. Yale J Biol Med 87:227–229
Becker AE, Kleinman A (2013) Mental health and the global agenda. N Engl J Med 369:66–73. https://doi.org/10.1037/tep0000128
Ordonez AE, Collins PY (2015) Advancing research to action in global child mental health. Child Adolesc Psychiatr Clin N Am 24:679–697. https://doi.org/10.1016/j.chc.2015.06.002
Cheung NWT (2013) Rural-to-urban migrant adolescents in Guangzhou, China: psychological health, victimization, and local and trans-local ties. Soc Sci Med 93:121–129. https://doi.org/10.1016/j.socscimed.2013.06.021
Peen J, Schoevers RA, Beekman AT, Dekker J (2010) The current status of urban-rural differences in psychiatric disorders. Acta Psychiatr Scand 121:84–93
Solmi F, Dykxhoorn J, Kirkbride JB (2017) Urban-rural differences in major mental health conditions. In: Okkels N, Kristiansen CB, Munk-Jørgensen P (eds) Mental health and illness in the city. Springer Science, NYC, pp 27–132
Generaal E, Timmermans EJ, Dekkers JEC et al (2018) Not urbanization level but socioeconomic, physical and social neighbourhood characteristics are associated with presence and severity of depressive and anxiety disorders. Psychol Med 49:149–161. https://doi.org/10.1017/S0033291718000612
Jones-Smith J, Popkin BM (2010) Understanding community context and adult health changes in China: development of an urbanicity scale. Soc Sci Med 71:1436–1446. https://doi.org/10.1016/j.socscimed.2010.07.027
Freeman H, Stansfield S (2008) The impact of the environment on psychiatric disorder. Routledge/Taylor & Francis Group, NYC
Helbich M (2018) Toward dynamic urban environmental exposure assessments in mental health research. Environ Res. https://doi.org/10.1016/j.envres.2017.11.006
Thomas SP (2013) The global phenomenon of urbanization and its effects on mental health. Issues Ment Health Nurs 34:139–140. https://doi.org/10.3109/01612840.2013.762857
Okkels N, Kristiansen C, Munk-Jorgensen P (2017) Mental health and illness in the city. Springer Science, NYC
World Bank (2019) Annual GDP growth percentage. https://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG?page=3. Accessed 6 Jun 2019
World Bank (2019) World bank country groups. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. Accessed 6 Jun 2019
World Bank (2019) Urban population (% of total population)—Vietnam. https://data.worldbank.org/indicator/SP.URB.TOTL.IN. Accessed 3 Jul 2019
Stahl MO, Harvey CF, van Green A et al (2016) Water Resources Research. Water Resour Res 52:6321–6334. https://doi.org/10.1111/j.1752-1688.1969.tb04897.x
Nguyen TM, Lin TH, Chan HP (2019) The environmental effects of urban development in Hanoi, Vietnam from satellite and meteorological observations from 1999–2016. Sustainability 11:1–24. https://doi.org/10.3390/su11061768
Weiss B, Dang M, Trung L et al (2014) A nationally representative epidemiological and risk factor assessment of child mental health in Vietnam. Int Perspect Psychol Res Pract Consult 3:139–153. https://doi.org/10.1037/ipp0000016
UNICEF (2018) Mental health and psychosocial wellbeing among children and young people in selected provinces and cities in Viet Nam. Hanoi, Vietnam
Weiss B, Ngo VK, Dang H-M et al (2012) A model for sustainable development of child mental health infrastructure in the lmic world: Vietnam as a case example. Int Perspect Psychol Res Pract Consult 1:63–77. https://doi.org/10.1037/a0027316
World Bank (2019) GNI per capita, by country. https://data.worldbank.org/indicator/NY.GNP.PCAP.CD?locations=VN. Accessed 4 Jul 2019
Achenbach TM, Rescorla LA (2012) Sách hướng dẫn sử dụng phiếu hỏi hệ thống đánh giá Achenbach. Vietnam National University Press, Hanoi, Vietnam
Rescorla L, Ivanova MY, Achenbach TM et al (2012) International epidemiology of child and adolescent psychopathology II: Integration and applications of dimensional findings from 44 societies. J Am Acad Child Adolesc Psychiatry 51:1273–1283. https://doi.org/10.1016/j.jaac.2012.09.012
Dang HM, Nguyen H, Weiss B (2017) Incremental validity of the child behavior checklist (CBCL) and the strengths and difficulties questionnaire (SDQ) in Vietnam. Asian J Psychiatr 29:96–100. https://doi.org/10.1016/j.ajp.2017.04.023
Dang MH, Weiss B, Nguyen MC (2012) Results of the first nationally representative child mental health epidemiological and risk factor assessment in Vietnam. Vietnam National University Press, Hanoi, Vietnam
Vlahov D, Galea S (2002) Urbanization, urbanicity, and health. J Urban Heal 79:S1–S12. https://doi.org/10.1093/jurban/79.suppl_1.S1
Miller DB, Townsend A (2005) Urban hassles as chronic stressors and adolescent mental health: the Urban hassles index. Br Treat Cris Interv 5:85–94. https://doi.org/10.1093/brief-treatment/mhi004
Shoffner MF, Vacc NA (2002) An analysis of the Community Safety Scale: a brief report. Meas Eval Couns Dev 35:49–55
Olive DJ (2017) Robust multivariate analysis. Springer, Basel
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Arlington
Aiken LS, West SG (1991) Multiple regression: testing and interpreting interactions. Sage Publications Inc, Thousand Oaks
Preacher KJ, Curran PJ, Bauer DJ (2006) Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. J Educ Behav Stat 31:437–448. https://doi.org/10.3102/10769986031004437
Achenbach TM, Ivanova MY, Rescorla LA (2017) Empirically based assessment and taxonomy of psychopathology for ages 1½–90+ years: Developmental, multi-informant, and multicultural findings. Compr Psychiatr 79:4–18. https://doi.org/10.1016/j.comppsych.2017.03.006
Stroup WW, Milliken GA (2018) SAS for mixed models: introduction and basic applications. SAS Institute, Cary
Achenbach TM, Rescorla LA (2004) The Achenbach System of Empirically Based Assessment (ASEBA) for Ages 1.5–18 Years. In: Maruish ME (ed) The use of psychological testing for treatment planning and outcomes assessment: Instruments for children and adolescents (Volume 2, 3rd ed.), 3rd ed. Lawrence Erlbaum Associates Publishers, Mahwah, NJ, pp 179–213
Harpin V (2017) The management of ADHD in children and young people. MacKeith Press, London
Farrington DP, Welsh BC (2007) Saving children from a life of crime: Early risk factors and effective interventions. Oxford University Press, NYC
McDonald KL, Gibson CE (2017) Peer Rejection and Disruptive Behavioral Disorders. In: Lochman JE, Matthys W (eds) The Wiley handbook of disruptive and impulse-control disorders. Wiley-Blackwell, NYC, pp 323–338
Camilleri VA (2007) Outcomes for at-risk children in the inner cite. Jessica Kingsley Publishers, London
Ritchie H, Roser M (2018) Urbanization. https://ourworldindata.org/urbanization. Accessed 22 Jul 2019
Acknowledgements
We gratefully acknowledge the families who participated in this study, and the support of research staff at participating educational institutions.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Weiss, B., Dang, HM., Lam, T.T. et al. Urbanization, and child mental health and life functioning in Vietnam: implications for global health disparities. Soc Psychiatry Psychiatr Epidemiol 55, 673–683 (2020). https://doi.org/10.1007/s00127-020-01838-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-020-01838-4