Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 49, Issue 10, pp 1569–1578 | Cite as

Disentangling the influence of neighborhood and individual characteristics on early residential mobility among newly diagnosed patients with schizophrenia: a multilevel analysis

  • André Ngamini Ngui
  • Philippe Apparicio
  • Marie-Josée Fleury
  • Jean-Pierre Grégoire
  • Jocelyne Moisan
  • Alain Lesage
  • Alain Vanasse
Original Paper

Abstract

Purpose

Early residential mobility of schizophrenic patients may relate to discontinuity of treatment and adverse outcome. However, factors influencing early residential mobility of these patients are still poorly examined. The aim of this study was to disentangle the influence of individual and neighborhood characteristics on early residential mobility of schizophrenic patients.

Methods

The study used administrative data of 13, 400 individuals newly diagnosed with schizophrenia in Quebec between 2001 and 2002. These individuals were nested in 163 different health territories. Multilevel analyses were used to assess the contribution of individual and neighborhood characteristics on early residential mobility.

Results

The final model indicates that at the individual level, being men, wonder patients and physical comorbidity increased the likelihood of early residential mobility whereas older patients were less likely to migrate earlier. The health territory level explains about 7 % of the variation of early residential mobility and variables influencing residential mobility at this level are the fourth and the third quartiles of the population density.

Conclusions

Factors influencing early residential mobility of schizophrenic patients are located at both individual and neighborhood levels. This suggests that policies targeting only one-level factors are unlikely to significantly delays early residential mobility.

Keywords

Early residential mobility Multilevel analysis Neighborhood and health Schizophrenia Public health 

Notes

Acknowledgments

This project was sponsored by AstraZeneca Canada Inc. through its “Prends soin de toi” program. None of the authors received salaries, consultation fees or any reimbursement from this company, nor held any shares in this organization.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The study and material was approved by the ethic committee of the Université de Sherbrooke.

References

  1. 1.
    Vanasse A, Courteau J, Fleury M-J, Grégoire J-P, Moisan J (2011) Treatment prevalence and incidence of schizophrenia in Quebec using a population health services perspective: different algorithms, different estimates. Soc Psychiatry Psychiatr Epidemiol 47(4):533–543PubMedCrossRefGoogle Scholar
  2. 2.
    Goeree R, Farahati F, Burke N, Blackhouse G, O’Reilly D, Pyne J, Tarride JE (2005) The economic burden of schizophrenia in Canada. Curr Med Res Opin 21(12):2017–2028PubMedCrossRefGoogle Scholar
  3. 3.
    Earp JA, Eng E, O’Malley MS, Altpeter M, Rauscher G, Mayne L, Mathews HF, Lynch KS, Qagish B (2002) Increasing use of mammography among older, rural African American Women: results from community trial. Am J Public Health 92(4):646–654PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Horwitz A (1977) Social network and pathways to psychiatric treatment. Soc Forces 56:86–105CrossRefGoogle Scholar
  5. 5.
    Levy-Storms L, Steven WP (2003) Use of mammography screening among older samoan women in Los Angeles county: a diffusion network approach. Soc Sci Med 281:2035–2040Google Scholar
  6. 6.
    Kang SH, Wallace NT, Hyun JK, Morris A, Coffman J, Bloom JR (2007) Social networks and their relationship to mental health service use and expenditures among Medicaid beneficiaries. Psychiatr Serv 58(5):689–695PubMedCrossRefGoogle Scholar
  7. 7.
    Albert M, Becker T, McCrone P, Thornicroft G (1998) Social networks and mental health service utilisation—a literature review. Int J Soc Psychiatry 44(4):248–266PubMedCrossRefGoogle Scholar
  8. 8.
    Lasebikan VO, Owoaje ET, Asuzu MC (2012) Social network as a determinant of pathway to mental health service utilization among psychotic patients in a Nigerian hospital. Ann Afr Med 11(1):12–20PubMedCrossRefGoogle Scholar
  9. 9.
    Berkman LF, Glass T, Brissette I, Seeman TE (2000) From social integration to health: Durkheim in the new millennium. Soc Sci Med 51(6):843–857PubMedCrossRefGoogle Scholar
  10. 10.
    Bentham G, Haynes R (1985) Health, personal mobility and the use of health services in rural Norfolk. J Rural Stud 1(3):231–239CrossRefGoogle Scholar
  11. 11.
    Berkanovic E, Telesky C, Sharon R (1981) Structural and social psychological factors in the decision to seek medical care for symptoms. Med Care 19(7):693–709PubMedCrossRefGoogle Scholar
  12. 12.
    Berkman LF, George FinkAssociate Editors:Bruce M, Kloet ERd, Robert R, George C, Andrew S, Noel R, Ian C, Giora F (2007) Social Networks and Social Isolation. In: Encyclopedia of stress. Academic Press, New York, pp 523–527Google Scholar
  13. 13.
    Beatty C, Lawless P, Pearson S, Wilson I (2009) Residential mobility and outcome change in deprived areas: evidence from the new deal for communities programme. Centre for Regional Economic and Social Research, Sheffield Hallam University, LondonGoogle Scholar
  14. 14.
    Lix LM, DeVerteuil G, Walker JR, Robinson RJ, Hinds AM, Roos LL (2007) Residential mobility of individuals with diagnosed schizophrenia: a comparison of single and multiple movers. Soc Psychiatry Psychiatr Epidemiol 42:221–228PubMedCrossRefGoogle Scholar
  15. 15.
    Lix LM, Hinds AM, DeVerteuil G, Robinson RJ, Walker JR, Roos LL (2006) Residential mobility and severe mental illness: a population-based analysis. Adm Policy Mental Health Serv Res 33(2):160–171CrossRefGoogle Scholar
  16. 16.
    Ngamini Ngui A, Cohen AA, Courteau J, Lesage A, Fleury M-J, Grégoire J-P, Moisan J, Vanasse A (2013) Does elapsed time between first diagnosis of schizophrenia and migration between health territories vary by place of residence? A survival analysis approach. Health Place 20:66–74PubMedCrossRefGoogle Scholar
  17. 17.
    Tulloch AD, Fearon P, Fahy T, David AS (2010) Residential mobility among individuals with severe mental illness: cohort study of UK700 participants. Soc Psychiatr Epidemiol 45:767–777CrossRefGoogle Scholar
  18. 18.
    McNaught AS, Jeffreys SE, Harvey CA, Quayle AS, King MB, Bird AS (1997) The Hampstead Schizophrenia Survey 1991. II: incidence and migration in inner London. Br J Psychiatry 170(4):307–311PubMedCrossRefGoogle Scholar
  19. 19.
    De Verteuil G, Hinds A, Lix L, Walker J, Robinson RJ, Roos LL (2007) Mental health and the city: intra-urban mobility among individuals with schizophrenia. Health Place 13:310–323CrossRefGoogle Scholar
  20. 20.
    McCarthy JF, Valenstein M, Blow FC (2007) Residential mobility among patients in the VA health system: associations with psychiatric morbidity, geographic accessibility, and community of care. Adm Policy Ment Health 34:448–455PubMedCrossRefGoogle Scholar
  21. 21.
    Tulloch AD, Fearon P, David AS (2011) Residential mobility among patients admitted to acute psychaitric wards. Health Place 17:859–866PubMedCrossRefGoogle Scholar
  22. 22.
    Kirby JB, Kaneda T (2005) Neighborhood socioeconomic disadvantage and access to health care. J Health Soc Behav 46(1):15–31PubMedCrossRefGoogle Scholar
  23. 23.
    Ngamini Ngui A, Apparicio P (2011) L’accessibilité potentielle aux services de santé mentale à Montréal: approche par les systèmes d’information géographique Revue d’Épidémiologie et de Santé Publique 59: 369–378Google Scholar
  24. 24.
    Ngamini Ngui A, Perreault M, Fleury M-J, Caron J (2012) A multi-level study of the determinants of mental health service utilization. Revue d’Épidémiologie et de Santé Publique 60:85–93PubMedCrossRefGoogle Scholar
  25. 25.
    Cho YI, Johnson TP, Fendrich M, Pickup L (2013) Treatment facility neighborhood environment and outpatient treatment completion. J Drug Issues 43(3):374–385. doi: 10.1177/0022042612472332 CrossRefGoogle Scholar
  26. 26.
    Ryan D, Dooley B, Benson C (2008) Theoretical perspectives on post-migration adaptation and psychological well-being among refugees: towards a resource-based model. J Refug Studies 21(1):1–18. doi: 10.1093/jrs/fem047 CrossRefGoogle Scholar
  27. 27.
    Clark WAV, Onaka JL (1983) Life cycle and housing adjustment as explanations of residential mobility. Urban Studies 20(1):47–57CrossRefGoogle Scholar
  28. 28.
    Clark WAV (2005) Intervening in the residential mobility process: neighborhood outcomes for low-income population. PNAS 102(43):15307–15312PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Loo C, Mar D (1982) Desired residential mobility in a low income ethnic community: a case study of Chinatown. J Soc Issues 38(3):95–106. doi: 10.1111/j.1540-4560.1982.tb01772.x CrossRefGoogle Scholar
  30. 30.
    Lee S (2002) The stigma of schizophrenia: a transcultural problem. Curr Opin Psychiatry 15(1):37–41CrossRefGoogle Scholar
  31. 31.
    Diez Roux AV, Mair C (2010) Neighborhoods and health. Ann N Y Acad Sci 1186:125–145PubMedCrossRefGoogle Scholar
  32. 32.
    Berkman LF, Glass T (2000) Social integration, social networks, social support, and health. In: Berkman LF, Kawachi I (eds) Social epidemiology. Oxford University Press, Oxford, pp 137–173Google Scholar
  33. 33.
    Stockdale SE, Wells KB, Tang L, Belin TR, Zhang L, Sherbourne CD (2007) The importance of social context: neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders. Soc Sci Med 65(9):1864–1881CrossRefGoogle Scholar
  34. 34.
    Browning CR, Cagney KA (2002) Neighborhood structural disadvantage, collective efficacy, and self-rated health in an urban setting. J Health Soc Behav 43:383–399PubMedCrossRefGoogle Scholar
  35. 35.
    Brown AF, Ang A, Pebley AR (2007) The relationship between neighborhood characteristics and self-rated health for adults with chronic conditions. Am J Public Health 97(5):926–932PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Van der Linden J, Drukker M, Gunther N, Feron F, Jv Os (2003) Children’s mental health service use, neighbourhood socioeconomic deprivation, and social capital. Soc Psychiatry Psychiatr Epidemiol 38:507–514PubMedCrossRefGoogle Scholar
  37. 37.
    Tamblyn R, Lavoie G, Petrella L, Monette J (1995) The use of prescription claims in pharmacoepidemiological research: the accuracy and comprehensiveness of the prescription claims database in Québec. J Clin Epidemiol 48(8):999–1009PubMedCrossRefGoogle Scholar
  38. 38.
    O.M.S (2008) Classification statistique internationale des maladies et des problèmes de santé connexes: CIM-10, vol 10. O.M.S, GenèveGoogle Scholar
  39. 39.
    Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA (2004) New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol 57(12):1288–1294PubMedCrossRefGoogle Scholar
  40. 40.
    Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi J, Saunders LD, Beck CA, Feasby TE, Ghali WA (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43(11):1130–1139PubMedCrossRefGoogle Scholar
  41. 41.
    D’Hoore W, Bouckaert A, Tilquin C (1996) Practical considerations on the use of the Charlson comorbidity index with administrative data bases. J Clin Epidemiol 49(12):1429–1433PubMedCrossRefGoogle Scholar
  42. 42.
    Barakett R (2002) Précis annoté de la ioi surles services de santé et les services sociaux, vol 3. Yvon Blais Inc., CowansvilleGoogle Scholar
  43. 43.
    Savard N, Levallois P, Rivest LP, Gingras S (2012) A study of the association between characteristics of CLSCs and the risk of small for gestational age births among term and preterm births in Quebec, Canada. Can J Public Health 103(2):152–157PubMedGoogle Scholar
  44. 44.
    Pampalon R, Raymond G (2003) Un indice de défavorisation pour la planification de la santé et du bien-être au Québec. Santé Société et Solidarité 1:191–208CrossRefGoogle Scholar
  45. 45.
    Pampalon R, Raymond G, Beaudry D, Gauthier D (1990) Les variations géographiques de la santé au Québec : une analyse de l’enquête Santé Québec par aire homogène. Cahiers de géographie du Québec 34(92):137–160CrossRefGoogle Scholar
  46. 46.
    Canada (2011) Census Dictionary. vol 98-301. Statistics CanadaGoogle Scholar
  47. 47.
    Pampalon R, Hamel D, Gamache P, Philibert MD, Raymond G, Simpson A (2012) An area-based material and social deprivation index for public health in Quebec and Canada. Can J Public Health Revue canadienne de sante publique 103(8 Suppl 2):S17–S22Google Scholar
  48. 48.
    Pampalon R, Hamel D, Gamache P (2010) Health inequalities in urban and rural Canada: comparing inequalities in survival according to an individual and area-based deprivation index. Health Place 16(2):416–420. doi: 10.1016/j.healthplace.2009.11.012 PubMedCrossRefGoogle Scholar
  49. 49.
    Pampalon R, Raymond G (2000) A deprivation index for health and welfare planning in Quebec. Chronic Dis Can 21(3):104–113PubMedGoogle Scholar
  50. 50.
    Lee M-A (2009) Neighborhood residential segregation and mental health: a multilevel analysis on Hispanic Americans in Chicago. Soc Sci Med 68:1975–1984PubMedCrossRefGoogle Scholar
  51. 51.
    Massey DS, Denton NA (1988) The dimensions of residential segregation. Soc Forces 67(2):281–315CrossRefGoogle Scholar
  52. 52.
    Greenland S (2000) Principles of multilevel modelling. Int J Epidemiol 29:158–167PubMedCrossRefGoogle Scholar
  53. 53.
    Leyland AH, Goldstein H (eds) (2001) Multilevel modelling of health statistics. Wiley, West SussexGoogle Scholar
  54. 54.
    Healy MJR (2001) Multilevel data and their analysis. In: Leyland AH, Goldstein H (eds) Multilevel modelling of health statistics. Wiley, West Sussex, pp 1–11Google Scholar
  55. 55.
    Hox J (2002) Multilevel analysis: techniques and applications. Lawrence Erlbaun Associates, MahwahGoogle Scholar
  56. 56.
    Rice N (2001) Binomial regression. In: Leyland AH, Goldstein H (eds) Multilevel modelling of health statistics. Wiley, West Sussex, pp 27–43Google Scholar
  57. 57.
    Snijders T, Bosker R (1999) Multilevel analysis: an introduction to basic and advanced mutlilevel modeling. SAGE Publications, LondonGoogle Scholar
  58. 58.
    Raudenbush SW, Bryk AS (2002) Hierarchical linear models: applications and data analysis methods, vol 2. Sage Publications, Thousand OaksGoogle Scholar
  59. 59.
    Twisk JWR (2006) Applied multilevel analysis: a practical guide. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  60. 60.
    Tabachnick BG, Fidell LS (2007) Using Multivariate Statistics, vol 5. Pearson Education Inc., New YorkGoogle Scholar
  61. 61.
    Wiseman RF (1980) Why older people move: theoretical issues. Res Aging 2(2):141–154CrossRefGoogle Scholar
  62. 62.
    Sergeant JF, Ekerdt DJ, Chapin RK (2010) Older adults’ expectations to move: do they predict actual community-based or nursing facility moves within 2 years? J Aging Health 22(7):1029–1053PubMedCrossRefGoogle Scholar
  63. 63.
    Schulz R, Brenner G (1977) Relocation of the aged: a review and theoretical analysis. J Gerontol 32(3):323–333PubMedCrossRefGoogle Scholar
  64. 64.
    Strohschein L (2012) I want to move, but cannot: characteristics of involuntary stayers and associations with health among Canadian seniors. J Aging Health 24(5):735–751PubMedCrossRefGoogle Scholar
  65. 65.
    Bijl RV, Ravelli A (2000) Psychiatric morbidity, service use, and need for care in the general population: results of the Netherlands mental health survey and incidence study. Am J Public Health 90(4):602–607PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Fox JW (1990) Social class, mental illness, and social mobility: the social selection-drift hypothesis for serious mental illness. Am Sociol Assoc 31(4):344–353Google Scholar
  67. 67.
    Hudson CG (2005) Socioeconomic status and mental illness: tests of the social causation and selection hypotheses. Am J Orthopsychiatry 75(1):3–18PubMedCrossRefGoogle Scholar
  68. 68.
    Aro S, Aro H, Keskimäki I (1995) Socio-economic mobility among patients with Schizophrenia or major affective disorder. A 17-year retrospective follow-up. Br J Psychiatry 166:759–767PubMedCrossRefGoogle Scholar
  69. 69.
    Becker DR, Drake RE, Bond GR, Xie H, Dain BJ, Harrison K (1998) Job terminations among persons with severe mental illness participating in supported employment. Community Ment Health J 34(1):71–82PubMedCrossRefGoogle Scholar
  70. 70.
    Clark WAV, Morrison PS (2012) Socio-spatial mobility and residential sorting: evidence from a large-scale survey. Urban Stud 49(15):3253–3270CrossRefGoogle Scholar
  71. 71.
    Genberg BL, Gange SJ, Go VF, Celentano DD, Kirk GD, Latkin CA, Mehta SH (2011) The effect of neighborhood deprivation and residential relocation on long-term injection cessation among injection drug users (IDUs) in Baltimore, Maryland. Addiction (Abingdon, England) 106(11):1966–1974CrossRefGoogle Scholar
  72. 72.
    Schaeffer JL, Ross RG (2002) Childhood-onset schizophrenia: premorbid and prodromal diagnostic and treatment histories. J Am Acad Child Adoslesc Psychiatry 41(5):538–545CrossRefGoogle Scholar
  73. 73.
    Eastwood JG, Jalaludin BB, Kemp LA, Phung HN, Adusumilli SK (2013) Clusters of maternal depressive symptoms in South Western Sydney, Australia. Spat Spat Temporal Epidemiol 4:25–31. doi: 10.1016/j.sste.2012.11.001 CrossRefGoogle Scholar
  74. 74.
    Wong D (2009) The modifiable areal unit problem (MAUP). In: Fotheringham SA, Rogerson PA (eds) The SAGE handbook of spatial analysis. SAGE, London, pp 105–123Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • André Ngamini Ngui
    • 1
    • 2
  • Philippe Apparicio
    • 3
  • Marie-Josée Fleury
    • 1
  • Jean-Pierre Grégoire
    • 4
  • Jocelyne Moisan
    • 4
  • Alain Lesage
    • 5
  • Alain Vanasse
    • 6
  1. 1.Centre de réadaptation en dépendance de MontréalInstitut UniversitaireMontrealCanada
  2. 2.Centre de Recherche-Hôpital Charles-Le Moyne (CR-HCLM)LongueuilCanada
  3. 3.Spatial Analysis and Regional Economics Laboratory, Centre Urbanisation Culture Société, Institut National de la Recherche ScientifiqueUniversité du QuébecMontrealCanada
  4. 4.Faculté de Pharmacie and Chair on Adherence to TreatmentsUniversité Laval and Centre de Recherche du CHU de QuébecLavalCanada
  5. 5.Centre de Recherche Fernand-SeguinInstitut Universitaire en Santé Mentale de MontréalMontrealCanada
  6. 6.Groupe PRIMUS, Centre de Recherche Étienne-LebelUniversité de SherbrookeSherbrookeCanada

Personalised recommendations