Identifying Social Determinants and Measuring Socioeconomic Inequalities in the Use of Four Different Mental Health Services by Australian Adolescents Aged 13–17 Years: Results from a Nationwide Study
Abstract
:1. Introduction
2. Subjects and Methodology
2.1. Data Source and Sample Size
2.2. Outcome Variables
2.3. Explanatory Variables
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | n | % |
---|---|---|
Age | Mean = 15.42, SD = 1.38 | |
Gender | ||
Boys | 1177 | 51.9 |
Girls | 1091 | 48.1 |
Country of Birth | ||
Overseas | 339 | 14.9 |
Australia | 1929 | 85.1 |
Place of residence | ||
Regional/remote | 801 | 35.3 |
Major cities | 1467 | 64.7 |
Parental education | ||
Year 10/11 | 722 | 31.8 |
Diploma | 819 | 36.1 |
Bachelor | 727 | 32.1 |
Parental employment | ||
Employed | 1730 | 76.3 |
Unemployed | 538 | 23.7 |
Family type | ||
Original | 1339 | 59.0 |
Blended and others | 929 | 41.0 |
Family cohesion | ||
Good | 1853 | 81.7 |
Poor | 415 | 18.3 |
Household income quintile | ||
Q1 (0–20%) | 402 | 17.2 |
Q2 (20–40%) | 473 | 20.9 |
Q3 (40–60%) | 400 | 17.6 |
Q4 (60–80%) | 543 | 23.9 |
Q5 (80–100%) | 450 | 19.8 |
Health Service | School Service | Telephone Service | Online Service | |||||
---|---|---|---|---|---|---|---|---|
Unadjusted OR (95% CI) | Adjusted OR (95% OR) | Unadjusted OR (95% CI) | Adjusted OR (95% OR) | Unadjusted OR (95% CI) | Adjusted OR (95% OR) | Unadjusted OR (95% CI) | Adjusted OR (95% OR) | |
Age | 1.11 ** (1.02–1.20) | 1.10 * (1.01–1.19) | 0.78 * (0.64–0.94) | - | 1.02 (0.86–1.21) | - | 1.15 *** (1.06–1.25) | 1.15 ** (1.06–1.25) |
Gender | ||||||||
Boys | Ref | Ref | Ref | - | Ref | Ref | Ref | Ref |
Girls | 1.68 *** (1.35–2.09) | 1.67 *** (1.34–2.08) | 1.51 (0.87–2.62) | 2.34 ** (1.44–3.80) | 2.29 ** (1.41–3.73) | 2.41 *** (1.93–3.02) | 2.38 *** (1.90–2.99) | |
Country of birth | ||||||||
Overseas | Ref | Ref | Ref | - | Ref | - | Ref | - |
Australia | 1.71 ** (1.20–2.41) | 1.65 ** (1.16–2.35) | 0.91 (0.43–1.91) | 1.40 (0.68–2.87) | 0.89 (0.67–1.21) | |||
Place of residence | ||||||||
Regional/remote | Ref | - | Ref | - | Ref | - | Ref | Ref |
Major cities | 1.10 (0.86–1.39) | 1.35 (0.72–2.52) | 1.21 (0.72–1.99) | 1.41 ** (1.09–1.83) | 1.31 * (1.00–1.71) | |||
Parental education | - | |||||||
Year 10/11 | Ref | - | Ref | - | Ref | Ref | Ref | |
Diploma | 1.02 (0.78–1.32) | 1.03 (0.52–2.05) | 0.94 (0.55–1.61) | 1.34 (1.02–1.76) | 1.34 (1.01–1.77) | |||
Bachelor | 0.93 (0.71–1.22) | 1.22 (0.62–2.42) | 0.77 (0.43–1.39) | 1.40 (1.07–1.85) | 1.37 (1.02–1.84) | |||
Parental employment | ||||||||
Unemployed | Ref | Ref | Ref | - | Ref | Ref | Ref | - |
Employed | 0.61 *** (0.48–0.78) | 0.71 * (0.55–0.92) | 0.88 (0.47–1.66) | 0.53 * (0.33–0.86) | 0.61 * (0.37–0.98) | 1.07 (0.83–1.39) | ||
Family type | ||||||||
Original | Ref | Ref | Ref | - | Ref | Ref | Ref | - |
Blended and others | 1.97 *** (1.58–2.44) | 1.72 *** (1.36–2.18) | 1.58 (0.91–2.75) | 2.51 *** (1.57–4.02) | 2.36 *** (1.46–3.78) | 1.06 (0.85–1.32) | ||
Family cohesion | ||||||||
Good | Ref | Ref | Ref | - | Ref | - | Ref | - |
Poor | 1.36 * (1.04–1.78) | 1.31 * (0.99–1.71) | 1.59 (0.84–2.99) | 1.35 (0.78–2.34) | 1.13 (0.85–1.49) | |||
Household income quintile | - | - | ||||||
Q1 (0–20%) | Ref | Ref | Ref | Ref | Ref | Ref | ||
Q2 (20–40%) | 0.79 (0.57–1.08) | 1.01 (0.72–1.41) | 0.93 (0.36–2.34) | 0.84 (0.45–1.56) | 1.62 (1.12–2.32) | 1.59 (1.09–2.31) | ||
Q3 (40–60%) | 0.52 *** (0.36–0.75) | 0.73 (0.49–1.09) | 1.22 (0.49–3.03) | 0.53 (0.25–1.10) | 1.53 (1.05–2.24) | 1.40 (0.95–2.06) | ||
Q4 (60–80%) | 0.53 *** (0.38–0.73) | 0.80 (0.55–1.16) | 1.07 (0.44–2.57) | 0.52 (0.26–1.01) | 1.16 (0.81–1.67) | 1.08 (0.74–1.58) | ||
Q5 (80–100%) | 0.58 ** (0.41–0.82) | 0.90 (0.61–1.32) | 1.15 (0.47–2.84) | 0.31 ** (0.13–0.71) | 1.58 ** (1.09–2.29) | 1.37 (0.93–2.03) |
Single Service Accessed | Multiple (Two or More) Services Accessed | |||
---|---|---|---|---|
Unadjusted OR (95% CI) | Adjusted OR (95% OR) | Unadjusted OR (95% CI) | Adjusted OR (95% OR) | |
Age | 1.04 (0.97–1.12) | - | 1.15 * (1.03–1.28) | 1.13 * (1.01–1.27) |
Gender | ||||
Boys | Ref | Ref | Ref | Ref |
Girls | 1.38 ** (1.13–1.68) | 1.37 ** (1.12–1.68) | 2.72 *** (2.00–3.69) | 2.67 *** (1.95–3.63) |
Country of birth | ||||
Overseas | Ref | - | Ref | - |
Australia | 1.19 (0.89–1.59) | 1.11 (0.73–1.68) | ||
Place of residence | ||||
Regional/remote | Ref | - | Ref | Ref |
Major cities | 1.08 (0.87–1.33) | 1.43 * (1.01–2.02) | 1.36 (0.96–1.94) | |
Parental education | ||||
Year 10/11 | Ref | - | Ref | - |
Diploma | 1.02 (0.81–1.31) | 1.21 (0.85–1.73) | ||
Bachelor | 0.98 (0.76–1.26) | 1.21 (0.84–1.75) | ||
Parental employment | ||||
Unemployed | Ref | - | Ref | - |
Employed | 0.81 (0.64–1.02) | 0.78 (0.56–1.08) | ||
Family type | ||||
Original | Ref | Ref | Ref | Ref |
Blended and others | 1.27 * (1.04–1.55) | 1.26 * (1.03–1.55) | 1.63 ** (1.22–2.18) | 1.59 ** (1.18–2.14) |
Family cohesion | ||||
Good | Ref | - | Ref | Ref |
Poor | 0.93 (0.71–1.21) | 1.53 * (1.08–2.17) | 1.51 * (1.06–2.16) | |
Household income quintile | ||||
Q1 (0–20%) | Ref | - | Ref | - |
Q2 (20–40%) | 0.92 (0.67–1.26) | 1.14 (0.73–1.78) | ||
Q3 (40–60%) | 0.85 (0.61–1.18) | 0.84 (0.51–1.37) | ||
Q4 (60–80%) | 0.71 (0.51–0.96) | 0.79 (0.50–1.26) | ||
Q5 (80–100%) | 0.81 (0.59–1.12) | 1.00 (0.62–1.59) |
Services | Concentration Index (CI) | Standard Error (CI) | p-Value |
---|---|---|---|
By each service | |||
Health service | −0.073 | 0.018 | <0.001 |
School service | 0.005 | 0.008 | 0.474 |
Telephone service | −0.032 | 0.009 | 0.002 |
Online services | 0.017 | 0.019 | 0.363 |
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Islam, M.I.; Salam, S.S.; Kabir, E.; Khanam, R. Identifying Social Determinants and Measuring Socioeconomic Inequalities in the Use of Four Different Mental Health Services by Australian Adolescents Aged 13–17 Years: Results from a Nationwide Study. Healthcare 2023, 11, 2537. https://doi.org/10.3390/healthcare11182537
Islam MI, Salam SS, Kabir E, Khanam R. Identifying Social Determinants and Measuring Socioeconomic Inequalities in the Use of Four Different Mental Health Services by Australian Adolescents Aged 13–17 Years: Results from a Nationwide Study. Healthcare. 2023; 11(18):2537. https://doi.org/10.3390/healthcare11182537
Chicago/Turabian StyleIslam, Md Irteja, Shumona Sharmin Salam, Enamul Kabir, and Rasheda Khanam. 2023. "Identifying Social Determinants and Measuring Socioeconomic Inequalities in the Use of Four Different Mental Health Services by Australian Adolescents Aged 13–17 Years: Results from a Nationwide Study" Healthcare 11, no. 18: 2537. https://doi.org/10.3390/healthcare11182537