Abstract
Purpose
This study explores the relationships between neighborhood structural differences such as socioeconomic status (SES), income inequality, and ethnic diversity on women’s mental health in Accra, Ghana.
Methods
The study used secondary data from the 2009 Women Health Survey Accra II, linked with the 2010 sub-metro level census figures on income inequality. The analytical sample consists of 2814 women nested within 195 enumeration areas (clusters) in the Accra Metropolitan Area (AMA). Multilevel binary logit and complimentary log–log models were used to analyze the data.
Results
Results suggest that social capital and neighborhood socioeconomic structural factors such SES, ethnic diversity, and housing ownership were associated with depressive symptoms, feeling downhearted, and self-reported health.
Conclusions
These findings suggest that policies and programs that improve the physical and economic conditions of deprived neighborhoods, as well as civic initiatives that improve social capital and cohesion, may be important for promoting collective actions and improving health outcomes in urban settings like Accra.
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References
Diez Roux, A. V., & Mair, C. (2010). Neighborhoods and health. Annals of the New York Academy of Sciences, 1186(1), 125–145. https://doi.org/10.1111/j.1749-6632.2009.05333.x.
Pickett, K. E., & Pearl, M. (2001). Multilevel analyzes of neighborhood socioeconomic context and health outcomes: a critical review. Journal of Epidemiology and Community Health, 55(2), 111–122. https://doi.org/10.1136/jech.55.2.111.
Pickett, K., & Wilkinson, R. (2011). The spirit level: Why greater equality makes societies stronger. Old Saybrook: Tantor Media.
Veenstra, G., Luginaah, I., Wakefield, S., Birch, S., Eyles, J., & Elliott, S. (2005). Who you know, where you live: Social capital, neighborhood and health. Social Science and Medicine, 60(12), 2799–2818. https://doi.org/10.1016/j.socscimed.2004.11.013.
Winkleby, M., Sundquist, K., & Cubbin, C. (2007). Inequities in CHD incidence and case fatality by neighborhood deprivation. American Journal of Preventive Medicine, 32(2), 97–106. https://doi.org/10.1016/j.amepre.2006.10.002.
Phelan, J. C., Link, B. G., & Tehranifar, P. (2010). Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. Journal of Health and Social Behavior, 51(Suppl), S28–S40. https://doi.org/10.1177/0022146510383498.
Link, B. G., Phelan, J. C., Miech, R., & Leckman, W. E. (2008). The resources that matter: fundamental social causes of health disparities and the challenge of intelligence. Journal of Health and Social Behavior, 49(1), 72–91.
Kim, D., & Kawachi, I. (2007). U.S. State-level social capital and health-related quality of life: multilevel evidence of main, mediating, and modifying effects. Annals of Epidemiology, 17(4), 258–269. https://doi.org/10.1016/j.annepidem.2006.10.002.
Sundquist, J., Johansson, S., Min, Y., & Sundquist, K. (2006). Low Linking Social Capital as a predictor of coronary heart disease in Sweden: A cohort study of 2.8 million people.Social Science and Medicine, 62(4), 954–963. https://doi.org/10.1016/j.socscimed.2005.06.049.
Uphoff, E. P., Pickett, K. E., Cabieses, B., Small, N., & Wright, J. (2013). A systematic review of the relationships between social capital and socioeconomic inequalities in health: A contribution to understanding the psychosocial pathway of health inequalities. International Journal for Equity in Health, 12, 1–12. ISI:000322405700001.
Layte, R. (2012). The association between income inequality and mental health: testing status anxiety, social capital, and neo-Materialist explanations. European Sociological Review, 28(4), 498–511. https://doi.org/10.1093/esr/jcr012.
Carpiano, R. M. (2007). Neighborhood social capital and adult health: An empirical test of a Bourdieu-based model. Health and Place, 13(3), 639–655. https://doi.org/10.1016/j.healthplace.2006.09.001.
Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: A causal review. Social Science & Medicine, 128, 316–326. https://doi.org/10.1016/j.socscimed.2014.12.031.
Kondo, N., Sembajwe, G., Kawachi, I., van Dam, R. M., Subramanian, S. V., & Yamagata, Z. (2009). Income inequality, mortality, and self rated health: meta-analysis of multilevel studies. BMJ, 339(nov102), b4471–b4471. https://doi.org/10.1136/bmj.b4471.
Kondo, N., van Dam, R. M., Sembajwe, G., Subramanian, S. V., Kawachi, I., & Yamagata, Z. (2012). Income inequality and health: the role of population size, inequality threshold, period effects and lag effects. Journal of Epidemiology & Community Health, 66(6), e11–e11. https://doi.org/10.1136/jech-2011-200321.
Arku, G., Luginaah, I., Mkandawire, P., Baiden, P., & Asiedu, A. B. (2011). Housing and health in three contrasting neighborhoods in Accra. Ghana. Social Science and Medicine, 72(11), 1864–1872. https://doi.org/10.1016/j.socscimed.2011.03.023.
Weeks, R. J., Getis, A., Stow, A. D., Hill, G. A., & David, R. (2012). Connecting the dots between health, poverty and place in Accra, Ghana. Annals of the Association of American Geographers, 102:5, 932–941. https://doi.org/10.1080/00045608.2012.671132.
Carpiano, R. M. (2006). Toward a neighborhood resource-based theory of social capital for health: Can Bourdieu and sociology help? Social Science & Medicine, 62(1), 165–175. https://doi.org/10.1016/j.socscimed.2005.05.020.
Carpiano, R. M. (2006). Toward a neighborhood resource-based theory of social capital for health: Can Bourdieu and sociology help? Social Science & Medicine, 62(1), 165–175. doi:https://doi.org/10.1016/j.socscimed.2005.05.020.
Bourdieu, P.. In: education. In J. E Richardson (ed.) (1986). The forms of capital. In Handbook of theory for sociology of Education. New York: Greenwood Press.
Bisung, E., & Elliott, S. J. (2014). Toward a social capital based framework for understanding the water-health nexus. Social Science and Medicine, 108, 194–200. https://doi.org/10.1016/j.socscimed.2014.01.042.
Bisung, E., Elliott, S. J., Schuster-Wallace, C. J., Karanja, D. M., & Abudho, B. (2014). Social capital, collective action and access to water in rural Kenya. Social Science and Medicine, 119, 147–154. https://doi.org/10.1016/j.socscimed.2014.07.060.
World Economic Forum. (2014). The 10 African cities poised for take-off. Accessed 16 January, 2016 from: http://www.weforum.org/agenda/2014/05/top-10-cities-forum-africa-2014.
Anim-Baidoo, I., Narh, C., Obiri, D., Ewerenonu-Laryea, C., Donkor, D., Adjei, D., Markakpo, U., et al. (2015). Cryptosporidial diarrhoea in children at a paediatric hospital in Accra, Ghana. International Journal of Tropical diseases & Health, 10(3), 1–13. https://doi.org/10.9734/IJTDH/2015/18532.
Ghana Statistical Service (2012). 2010 Population and housing census: regional analytical report—Greater Accra Region. Ghana Statistical Service: Accra.
Fink, G., Weeks, J. R., & Hill, G. A. (2012). Income and health in Accra, Ghana: Results from a time use and health study. American Journal of Tropical Medicine Hygiene, 87(4), 608–615.
Hill, A., & Douptcheva, N. (2011). Final Report on the Women’s Health Study of Accra Wave II 2008/2009 (WHSA II). Technical Report No. 91. Accra, Ghana: ISSER, University of Ghana. Accessed on July 11, 2017 From: https://geog.sdsu.edu/Research/Projects/IPC/publication/WHSA-91.PDF.
Dadu, R. B., Anarfi, J. K., Adanu, R. M., Seffa, J., Darko, R., & Hill, A. G. (2011). The health of the “older women" in Accra, Ghana: results of the women health study of Accra. Journal of Cross Cultural Gerontology, 26, 299–314.
Ghana Statistical Service. (2015). Ghana poverty mapping report. Ghana Statistical Service: Accessed January 16, 2016 from:http://www.statsghana.gov.gh/docfiles/publications/POVERTYMAPFORGHANA-05102015.pdf.
Dunn, J. R. (2002). Housing and inequalities in health: a study of socioeconomic dimensions of housing and self reported health from a survey of Vancouver residents. Journal of Epidemiology and Community Health, 56(9), 671–681. https://doi.org/10.1136/jech.56.9.671.
Udofia, E. A., Yawson, A. E., Aduful, K. E., & Bwambale, F. M. (2014). Residential characteristics as correlates of occupants’ health in the Greater Accra Region, Ghana. BMC Public Health, 14(1), 244. doi:https://doi.org/10.1186/1471-2458-14-244.
Rabe-Hesketh, S., & Skrondal, A. (2008). Multilevel and longitudinal modelling using stata, (slide 3), p. 562.
Raudenbush, S., & Anthony, B. (2002). Hierarchical linear models: Applications and data analysis methods. Thousand Oaks, CA: Sage.
Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. Oxford: Oxford University Press.
Burnham, K. P., & Anderson, D. R. (2004). Multimodel inference understanding AIC and BIC in model selection. Sociology Methodology Research, 33(2), 261–304.
Wilkinson, R. G., & Pickett, K. E. (2006). Income inequality and population health: A review and explanation of the evidence. Social Science & Medicine, 62(7), 1768–1784. https://doi.org/10.1016/j.socscimed.2005.08.036.
Bécares, L., Cormack, D., & Harris, R. (2013). Ethnic density and area deprivation: Neighborhood effects on Māori health and racial discrimination in Aotearoa/New Zealand. Social Science and Medicine, 88, 76–82.
Bécares, L., Nazroo, J., & Stafford, M. (2009). The buffering effects of ethnic density on experienced racism and health. Health & Place, 15, 670–678.
Parks, J. M., Doodoo, F. N., & Ayerno, K. P. (2014). Applying neighborhood-effect research to a global south city: a case study in Accra, Ghana’s low - income areas. The Global South, 8(2), 119–138.
Agyei-Mensah, S., & Owusu, G. (2010). Segregated by neighborhoods? a portrait of ethnic diversity in the neighborhoods of the Accra metropolitan Area, Ghana. Population, Space, Place, 16, 499–516.
Luginaah, I., Arku, G., & Baiden, P. (2010). Housing and health in Ghana: The psychosocial impacts of renting a home. International Journal of Environmental Research and Public Health, 7(2), 528–545. https://doi.org/10.3390/ijerph7020528.
Craig, R. W., & Song, X. (2011). The impact of education on unemployment incidence and re-employment success: Evidence from the US Labour Market. Labour Economics, 18(4), 453–463.
Baiden, P., Arku, G., Luginaah, I., & Asiedu, A. B. (2011). An assessment of residents’ housing satisfaction and coping in Accra, Ghana. Journal of Public Health, 19(1), 29–37. https://doi.org/10.1007/s10389-010-0348-4.
Wilkinson, R. G., & Marmot, M. G. (2003). Social determinants of health: the solid facts. Geneva: World Health Organization.
Wilkinson, R. G., & Pickett, K. E. (2009). Income inequality and social dysfunction. Annual Review of Sociology, 35(1), 493–511. https://doi.org/10.1146/annurev-soc-070308-115926.
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Bisung, E., Kangmennaang, J. & Luginaah, I. Neighborhood structural differences and women’s mental health: an empirical study in Accra, Ghana. Qual Life Res 27, 661–671 (2018). https://doi.org/10.1007/s11136-017-1731-1
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DOI: https://doi.org/10.1007/s11136-017-1731-1