Olga Tymejczyk1, Vanessa R Rivera2, Mireille Peck3, Audrey Dorélien4, Jacky S Petion3, Grace Seo5, Kathleen F Walsh6, Jean W Pape7, Margaret L McNAIRY8, Daniel W Fitzgerald6, Denis Nash9, Angela Parcesepe10. 1. Institute of Implementation Science in Population Health, City University of New York, New York, NY 10027, USA; Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA. Electronic address: olga.tymejczyk@sph.cuny.edu. 2. Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au- Prince, Haiti; Center for Global Health, Weill Cornell Medical College, New York, NY, USA. 3. Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au- Prince, Haiti. 4. Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN, USA. 5. Center for Global Health, Weill Cornell Medical College, New York, NY, USA. 6. Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au- Prince, Haiti; Center for Global Health, Weill Cornell Medical College, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA. 7. Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au- Prince, Haiti; Department of Medicine, Weill Cornell Medical College, New York, NY, USA. 8. Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA. 9. Institute of Implementation Science in Population Health, City University of New York, New York, NY 10027, USA; Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA. 10. Institute of Implementation Science in Population Health, City University of New York, New York, NY 10027, USA; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract
BACKGROUND: Almost one billion people live in slum environments across low- and middle-income countries. Little is known about the mental health status of slum residents or its associations with living conditions. METHODS: A cross-sectional, population-representative survey was conducted among 892 adults in four slum communities in Port-au-Prince. Psychological distress was assessed with the Kessler Psychological Distress Scale (K-6). Log-binomial regression modeled the association of sociodemographic variables, living conditions, and material hardship and severe psychological distress [SPD]. RESULTS: Eighty-six percent of adults reported psychological distress (24% severe and 62% moderate). Reliance on an outdoor drinking water source (versus bottled water) and a pit toilet (versus a flush toilet) were marginally positively associated with SPD (adjusted prevalence ratio [aPR]=1.42, 95% confidence interval [CI]: 1.00-2.02 and aPR=1.74, 95% CI: 0.96-3.15, respectively). The prevalence of SPD was higher among women (versus men, aPR=1.66, 95% CI: 1.26-2.19), residents who had foregone healthcare to afford food (versus those who had never done so, aPR=1.60, 95% CI: 1.16-2.45), and persons who drank alcohol at least twice a week (versus monthly or less, aPR=1.73, 95% CI: 1.22-2.45). LIMITATIONS: Data were cross-sectional and lacked information on potential risk factors such as exposure to trauma. CONCLUSIONS: Psychological distress was highly prevalent and associated with poor living conditions. Prospective studies on the mechanisms through which slum living conditions are associated with psychological distress are needed. Research should also assess the feasibility and acceptability of implementation strategies to increase access to mental health screening and treatment for slum residents.
BACKGROUND: Almost one billion people live in slum environments across low- and middle-income countries. Little is known about the mental health status of slum residents or its associations with living conditions. METHODS: A cross-sectional, population-representative survey was conducted among 892 adults in four slum communities in Port-au-Prince. Psychological distress was assessed with the Kessler Psychological Distress Scale (K-6). Log-binomial regression modeled the association of sociodemographic variables, living conditions, and material hardship and severe psychological distress [SPD]. RESULTS: Eighty-six percent of adults reported psychological distress (24% severe and 62% moderate). Reliance on an outdoor drinking water source (versus bottled water) and a pit toilet (versus a flush toilet) were marginally positively associated with SPD (adjusted prevalence ratio [aPR]=1.42, 95% confidence interval [CI]: 1.00-2.02 and aPR=1.74, 95% CI: 0.96-3.15, respectively). The prevalence of SPD was higher among women (versus men, aPR=1.66, 95% CI: 1.26-2.19), residents who had foregone healthcare to afford food (versus those who had never done so, aPR=1.60, 95% CI: 1.16-2.45), and persons who drank alcohol at least twice a week (versus monthly or less, aPR=1.73, 95% CI: 1.22-2.45). LIMITATIONS: Data were cross-sectional and lacked information on potential risk factors such as exposure to trauma. CONCLUSIONS: Psychological distress was highly prevalent and associated with poor living conditions. Prospective studies on the mechanisms through which slum living conditions are associated with psychological distress are needed. Research should also assess the feasibility and acceptability of implementation strategies to increase access to mental health screening and treatment for slum residents.
Authors: Ronald C Kessler; Peggy R Barker; Lisa J Colpe; Joan F Epstein; Joseph C Gfroerer; Eva Hiripi; Mary J Howes; Sharon-Lise T Normand; Ronald W Manderscheid; Ellen E Walters; Alan M Zaslavsky Journal: Arch Gen Psychiatry Date: 2003-02
Authors: Olga Tymejczyk; Margaret L McNairy; Jacky S Petion; Vanessa R Rivera; Audrey Dorélien; Mireille Peck; Grace Seo; Kathleen F Walsh; Daniel W Fitzgerald; Robert N Peck; Ashish Joshi; Jean W Pape; Denis Nash Journal: J Hypertens Date: 2019-04 Impact factor: 4.844
Authors: Ashish Chaddha; Elizabeth A Robinson; Eva Kline-Rogers; Tina Alexandris-Souphis; Melvyn Rubenfire Journal: Am J Med Date: 2016-06-08 Impact factor: 4.965
Authors: Margaret L McNairy; Olga Tymejczyk; Vanessa Rivera; Grace Seo; Audrey Dorélien; Mireille Peck; Jacky Petion; Kathleen Walsh; Anna Bolgrien; Denis Nash; Jean Pape; Daniel W Fitzgerald Journal: J Urban Health Date: 2019-12 Impact factor: 3.671
Authors: Bradley H Wagenaar; Ashley K Hagaman; Bonnie N Kaiser; Kristen E McLean; Brandon A Kohrt Journal: BMC Psychiatry Date: 2012-09-19 Impact factor: 3.630