Psychological distress among a population-representative sample of residents of four slum neighborhoods in Port-au-Prince, Haiti.
Haiti
Material hardship
Psychological distress
Slum
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
15 02 2020
15 02 2020
Historique:
received:
07
03
2019
revised:
25
10
2019
accepted:
21
11
2019
pubmed:
11
12
2019
medline:
7
2
2021
entrez:
11
12
2019
Statut:
ppublish
Résumé
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. 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]. 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). Data were cross-sectional and lacked information on potential risk factors such as exposure to trauma. 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.
Sections du résumé
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.
Identifiants
pubmed: 31818783
pii: S0165-0327(19)30588-9
doi: 10.1016/j.jad.2019.11.103
pmc: PMC6989354
mid: NIHMS1546115
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
241-245Subventions
Organisme : NICHD NIH HHS
ID : R24 HD041023
Pays : United States
Organisme : NIMH NIH HHS
ID : K01 MH114721
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009337
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD041023
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW010062
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009606
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI069421
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL143788
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD050924
Pays : United States
Organisme : NIAID NIH HHS
ID : K24 AI098627
Pays : United States
Informations de copyright
Copyright © 2019. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest All authors declare no conflicts of interest.
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