A population view of mental illness in South Australia: broader issues than location.

Kerena A. Eckert, David Wilkinson, Anne Taylor, Simon Stewart, Graeme R. Tucker

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

INTRODUCTION: There is growing evidence in Australia and elsewhere to indicate that prevalence rates of mental illness are no higher in rural and remote areas than in urban areas. However, it is generally perceived that people from rural and remote areas are at heightened risk of mental illness, because many psychosocial determinants of health are magnified by factors related to remoteness. In this study we attempt to unpack the factors guiding prevalence rates of mental illness to determine if remoteness per se is an important determinant of mental illness. METHODS: Analysis of data from a cross-sectional, population-based, computer-assisted telephone interview survey in 2000. Respondents included 2545 South Australian adults, aged 18 years or more. The mental illness measure was self-reported, medically confirmed depression, anxiety or stress related problems in the previous 12 months and receiving treatment. Remoteness was determined using the Accessibility and Remoteness Index of Australia (ARIA). Psychosocial measures consisted of major stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviours. RESULTS: Unadjusted odds of mental illness were lower among residents of accessible and remote/very remote areas than for those from highly accessible areas (OR [odds ratio] 0.67, 95% CI 0.50-0.91 and OR 0.73, 0.54-1.00). After controlling for the joint effects of stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviors, odds of mental illness did not vary by ARIA category (highly accessible [reference category]; accessible: OR 0.90 95% CI 0.60-1.31; moderately accessible: OR 0.80, 95% CI 0.45-1.43; remote/very remote: OR 0.70, 95% CI 0.44-1.03). The most important predictors of mental illness in the multivariate logistic model were female sex; smoking; low consumption of vegetables; low exercise; a physical condition; perceived lack of control with life in general, personal life, job security or health; and major stressful events such as family or domestic violence and the death of someone close. CONCLUSIONS: Remoteness per se was not associated with mental illness, either directly or indirectly, as an important confounder in stressful life event/mental illness associations. Psychosocial factors were more important determinants of mental illness.

LanguageEnglish
Number of pages1
JournalRural and remote health
Volume6
Issue number2
Publication statusPublished - 1 Jan 2006
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medical Services
  • Health(social science)
  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health

Cite this

Eckert, Kerena A. ; Wilkinson, David ; Taylor, Anne ; Stewart, Simon ; Tucker, Graeme R. / A population view of mental illness in South Australia : broader issues than location. In: Rural and remote health. 2006 ; Vol. 6, No. 2.
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abstract = "INTRODUCTION: There is growing evidence in Australia and elsewhere to indicate that prevalence rates of mental illness are no higher in rural and remote areas than in urban areas. However, it is generally perceived that people from rural and remote areas are at heightened risk of mental illness, because many psychosocial determinants of health are magnified by factors related to remoteness. In this study we attempt to unpack the factors guiding prevalence rates of mental illness to determine if remoteness per se is an important determinant of mental illness. METHODS: Analysis of data from a cross-sectional, population-based, computer-assisted telephone interview survey in 2000. Respondents included 2545 South Australian adults, aged 18 years or more. The mental illness measure was self-reported, medically confirmed depression, anxiety or stress related problems in the previous 12 months and receiving treatment. Remoteness was determined using the Accessibility and Remoteness Index of Australia (ARIA). Psychosocial measures consisted of major stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviours. RESULTS: Unadjusted odds of mental illness were lower among residents of accessible and remote/very remote areas than for those from highly accessible areas (OR [odds ratio] 0.67, 95{\%} CI 0.50-0.91 and OR 0.73, 0.54-1.00). After controlling for the joint effects of stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviors, odds of mental illness did not vary by ARIA category (highly accessible [reference category]; accessible: OR 0.90 95{\%} CI 0.60-1.31; moderately accessible: OR 0.80, 95{\%} CI 0.45-1.43; remote/very remote: OR 0.70, 95{\%} CI 0.44-1.03). The most important predictors of mental illness in the multivariate logistic model were female sex; smoking; low consumption of vegetables; low exercise; a physical condition; perceived lack of control with life in general, personal life, job security or health; and major stressful events such as family or domestic violence and the death of someone close. CONCLUSIONS: Remoteness per se was not associated with mental illness, either directly or indirectly, as an important confounder in stressful life event/mental illness associations. Psychosocial factors were more important determinants of mental illness.",
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A population view of mental illness in South Australia : broader issues than location. / Eckert, Kerena A.; Wilkinson, David; Taylor, Anne; Stewart, Simon; Tucker, Graeme R.

In: Rural and remote health, Vol. 6, No. 2, 01.01.2006.

Research output: Contribution to journalArticle

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N2 - INTRODUCTION: There is growing evidence in Australia and elsewhere to indicate that prevalence rates of mental illness are no higher in rural and remote areas than in urban areas. However, it is generally perceived that people from rural and remote areas are at heightened risk of mental illness, because many psychosocial determinants of health are magnified by factors related to remoteness. In this study we attempt to unpack the factors guiding prevalence rates of mental illness to determine if remoteness per se is an important determinant of mental illness. METHODS: Analysis of data from a cross-sectional, population-based, computer-assisted telephone interview survey in 2000. Respondents included 2545 South Australian adults, aged 18 years or more. The mental illness measure was self-reported, medically confirmed depression, anxiety or stress related problems in the previous 12 months and receiving treatment. Remoteness was determined using the Accessibility and Remoteness Index of Australia (ARIA). Psychosocial measures consisted of major stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviours. RESULTS: Unadjusted odds of mental illness were lower among residents of accessible and remote/very remote areas than for those from highly accessible areas (OR [odds ratio] 0.67, 95% CI 0.50-0.91 and OR 0.73, 0.54-1.00). After controlling for the joint effects of stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviors, odds of mental illness did not vary by ARIA category (highly accessible [reference category]; accessible: OR 0.90 95% CI 0.60-1.31; moderately accessible: OR 0.80, 95% CI 0.45-1.43; remote/very remote: OR 0.70, 95% CI 0.44-1.03). The most important predictors of mental illness in the multivariate logistic model were female sex; smoking; low consumption of vegetables; low exercise; a physical condition; perceived lack of control with life in general, personal life, job security or health; and major stressful events such as family or domestic violence and the death of someone close. CONCLUSIONS: Remoteness per se was not associated with mental illness, either directly or indirectly, as an important confounder in stressful life event/mental illness associations. Psychosocial factors were more important determinants of mental illness.

AB - INTRODUCTION: There is growing evidence in Australia and elsewhere to indicate that prevalence rates of mental illness are no higher in rural and remote areas than in urban areas. However, it is generally perceived that people from rural and remote areas are at heightened risk of mental illness, because many psychosocial determinants of health are magnified by factors related to remoteness. In this study we attempt to unpack the factors guiding prevalence rates of mental illness to determine if remoteness per se is an important determinant of mental illness. METHODS: Analysis of data from a cross-sectional, population-based, computer-assisted telephone interview survey in 2000. Respondents included 2545 South Australian adults, aged 18 years or more. The mental illness measure was self-reported, medically confirmed depression, anxiety or stress related problems in the previous 12 months and receiving treatment. Remoteness was determined using the Accessibility and Remoteness Index of Australia (ARIA). Psychosocial measures consisted of major stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviours. RESULTS: Unadjusted odds of mental illness were lower among residents of accessible and remote/very remote areas than for those from highly accessible areas (OR [odds ratio] 0.67, 95% CI 0.50-0.91 and OR 0.73, 0.54-1.00). After controlling for the joint effects of stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviors, odds of mental illness did not vary by ARIA category (highly accessible [reference category]; accessible: OR 0.90 95% CI 0.60-1.31; moderately accessible: OR 0.80, 95% CI 0.45-1.43; remote/very remote: OR 0.70, 95% CI 0.44-1.03). The most important predictors of mental illness in the multivariate logistic model were female sex; smoking; low consumption of vegetables; low exercise; a physical condition; perceived lack of control with life in general, personal life, job security or health; and major stressful events such as family or domestic violence and the death of someone close. CONCLUSIONS: Remoteness per se was not associated with mental illness, either directly or indirectly, as an important confounder in stressful life event/mental illness associations. Psychosocial factors were more important determinants of mental illness.

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