title: Inequalities in mental health in the spanish autonomous communities: a multilevel study.
abstract: The aim of this study was to analyze inequalities in the prevalence of poor mental health and their association with socioeconomic variables and with the care network in the Autonomous Communities in Spain. A cross-sectional multilevel study was performed, which analyzed individual data from the National Health Survey in Spain (ENS), in 2006 (n = 29,476 people over the age of 16). The prevalence of poor mental health was the dependent variable, measured by the General Health Questionnaire (GHQ-12 > = 3). Individual and contextual socioeconomic variables, along with mental health services in the Autonomous Communities, were included as independent variables. Models of multilevel logistic regression were used, and odds ratios (OR) were obtained, with confidence intervals (CI) of 95%. The results showed that there are inequalities in the prevalence of poor mental health in Spain, associated to contextual variables, such as unemployment rate (men OR 1.04 CI 1.01-1.07; women OR 1.02 CI 1.00-1.05). On the other hand, it was observed that inequalities in the mental health care resources in the Autonomous Communities also have an impact on poor mental health.
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul (Brazil).
authors.forename: Kátia B
authors.initials: KB
authors.lastname: Rocha
authors.affiliation: Agència de Salut Pública de Barcelona (Spain).
authors.forename: Katherine
authors.initials: K
authors.lastname: Perez
authors.affiliation: Agència de Salut Pública de Barcelona (Spain).
authors.forename: Maica
authors.initials: M
authors.lastname: Rodriguez-Sanz
authors.affiliation: University of Toronto (Canada).
authors.forename: Carles
authors.initials: C
authors.lastname: Muntaner
authors.affiliation: CIBER en Epidemiología y Salud Pública (CIBERESP) (Spain).
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Agència de Salut Pública de Barcelona (Spain).
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012959:Socioeconomic Factors; D013030:Spain; D055815:Young Adult
keywords: inequalities in health; mental health; multilevel studies; public health