title: Mental health in the slums of Dhaka - a geoepidemiological study.
abstract: BACKGROUND
  Urban health is of global concern because the majority of the world's population lives in urban areas. Although mental health problems (e.g. depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum of mental well-being in urban slums and only poor knowledge exists on health promotive socio-physical environments in these areas. Using a geo-epidemiological approach, the present study identified factors that contribute to the mental well-being in the slums of Dhaka, which currently accommodates an estimated population of more than 14 million, including 3.4 million slum dwellers.
  
  
  METHODS
  The baseline data of a cohort study conducted in early 2009 in nine slums of Dhaka were used. Data were collected from 1,938 adults (≥ 15 years). All respondents were geographically marked based on their households using global positioning systems (GPS). Very high-resolution land cover information was processed in a Geographic Information System (GIS) to obtain additional exposure information. We used a factor analysis to reduce the socio-physical explanatory variables to a fewer set of uncorrelated linear combinations of variables. We then regressed these factors on the WHO-5 Well-being Index that was used as a proxy for self-rated mental well-being.
  
  
  RESULTS
  Mental well-being was significantly associated with various factors such as selected features of the natural environment, flood risk, sanitation, housing quality, sufficiency and durability. We further identified associations with population density, job satisfaction, and income generation while controlling for individual factors such as age, gender, and diseases.
  
  
  CONCLUSIONS
  Factors determining mental well-being were related to the socio-physical environment and individual level characteristics. Given that mental well-being is associated with physiological well-being, our study may provide crucial information for developing better health care and disease prevention programmes in slums of Dhaka and other comparable settings.
authors.affiliation: Geomatics Lab, Geography Department, Humboldt-Universität zu Berlin, Berlin, Germany. Oliver.Gruebner@geo.hu-berlin.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Gruebner
authors.forename: M Mobarak H
authors.initials: MM
authors.lastname: Khan
authors.forename: Sven
authors.initials: S
authors.lastname: Lautenbach
authors.forename: Daniel
authors.initials: D
authors.lastname: Müller
authors.forename: Alexander
authors.initials: A
authors.lastname: Krämer
authors.forename: Tobia
authors.initials: T
authors.lastname: Lakes
authors.forename: Patrick
authors.initials: P
authors.lastname: Hostert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001459:Bangladesh / Q000453:epidemiology; D015331:Cohort Studies; D016021:Epidemiologic Studies; D005260:Female; D040362:Geographic Information Systems; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D015233:Models, Statistical; D011204:Poverty Areas; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012931:Social Environment; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*