title: Perception of environmental problems and common mental disorders (CMD).
abstract: BACKGROUND
  In the past few years, there has been increasing interest in studying the association between problems in the neighbourhood environment and health indicators. The objective of this study is to examine the relationship between the perception of environmental problems by individuals and the prevalence of common mental disorders (CMD) in Spain.
  
  
  METHODS
  A cross-sectional study using data from a large scale national representative survey of households (the 2006 Spanish National Health Survey). Participants included in the study were aged between 16 and 64 years (n = 23,760). The dependent variable was common mental disorders assessed with the General Health Questionnaire (GHQ-12). The independent variable was the individual's perception of environmental problems. Raw and adjusted Odds Ratios and their confidence intervals (95%) were calculated by fitting logistic regression models adjusting for age, marital status, work situation, social class, rural or urban area, country of origin, restrictions in carrying out activities of daily life due to a health problem and social support.
  
  
  RESULTS
  The individuals who reported environmental problems had a higher prevalence of CMD. There was a clear increasing gradient in CMD prevalence with the increase in the number of environmental problems mentioned. Among the subjects who reported to have 1 or no environmental problem the prevalence of CMD was 11.8% (men) and 18.7% (women), and among those who mentioned 6 or more problems, the prevalence increased to 20.8% (men) and 35.4% (women). After adjusting for all the co-variables, there is an association between environmental problems and CMD (men OR 1.44, 95% CI 1.08-1.66; women OR 1.46, 95% CI 1.27-1.67). The environmental problems most strongly associated with the prevalence of CMD are noise, bad smell, air pollution, and lack of green areas.
  
  
  CONCLUSIONS
  Our findings show that individuals who perceive environmental problems in their neighbourhood have a higher prevalence of CMD, even after adjusting for all co-variables. In addition, there is a clear increasing gradient in the prevalence of CMD with the increase in the number of environmental problems. Efforts to reduce the prevalence of CMD must be directed to improve individual and contextual risks.
authors.affiliation: Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain. krocha@aspb.cat
authors.forename: Kátia
authors.initials: K
authors.lastname: Rocha
authors.forename: Katherine
authors.initials: K
authors.lastname: Pérez
authors.forename: Maica
authors.initials: M
authors.lastname: Rodríguez-Sanz
authors.forename: Jordi E
authors.initials: JE
authors.lastname: Obiols
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D010465:Perception; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012923:Social Class; D012944:Social Support; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult