%0 Journal Article
%T A spatial epidemiological analysis of self-rated mental health in the slums of Dhaka
%A Oliver Gruebner
%A Md Mobarak H Khan
%A Sven Lautenbach
%A Daniel M¨¹ller
%A Alexander Kraemer
%A Tobia Lakes
%A Patrick Hostert
%J International Journal of Health Geographics
%D 2011
%I BioMed Central
%R 10.1186/1476-072x-10-36
%X We applied a spatial epidemiological approach, including non-spatial ANOVA/ANCOVA, as well as global and local univariate and bivariate Moran's I statistics. The WHO-5 Well-being Index was used as a measure of self-rated mental health.We found that poor mental health (WHO-5 scores < 13) among the adult population (age ¡Ư15) was prevalent in all slum settlements. We detected spatially autocorrelated WHO-5 scores (i.e., spatial clusters of poor and good mental health among different population groups). Further, we detected spatial associations between mental health and housing quality, sanitation, income generation, environmental health knowledge, education, age, gender, flood non-affectedness, and selected properties of the natural environment.Spatial patterns of mental health were detected and could be partly explained by spatially correlated HDF. We thereby showed that the socio-physical neighbourhood was significantly associated with health status, i.e., mental health at one location was spatially dependent on the mental health and HDF prevalent at neighbouring locations. Furthermore, the spatial patterns point to severe health disparities both within and between the slums. In addition to examining health outcomes, the methodology used here is also applicable to residuals of regression models, such as helping to avoid violating the assumption of data independence that underlies many statistical approaches. We assume that similar spatial structures can be found in other studies focussing on neighbourhood effects on health, and therefore argue for a more widespread incorporation of spatial statistics in epidemiological studies.The number of people living in slum communities has been increasing rapidly in the megacities of developing countries over the past 20 years [1]. Indeed, although there are already at least one billion people living in slums today, it is projected that this number will double by 2030 [2]. Dhaka, the capital of Bangladesh, is one of the fastest
%U http://www.ij-healthgeographics.com/content/10/1/36