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DOI: 10.1055/a-2326-6768
Spatial and Socioeconomic Patterns of Mental Health and Healthcare Utilization in Cologne, Germany
Article in several languages: English | deutsch Funding Information We acknowledge support for the Article Processing Charge from the DFG (German Research Foundation, 491454339). — http://dx.doi.org/10.13039/501100001659; 491454339
Abstract
Background Children and adolescents are significantly tied to their family's socioeconomic position and living environment. Neighbourhood and the living environment have been identified as potential risk factors for mental disorders in this age group.
Aim of the Study The aim of the study was to investigate the distribution of mental and behavioural disorders (prevalence) and the provision of mental health services for children and adolescents aged 0–19 years in the city of Cologne. In particular, the study aimed to examine the association of these factors with area deprivation and the availability of mental health services covered by statutory health insurance. Finally, possible spatial variations in these aspects were analysed.
Method Claims data of children and adolescents aged 0 to 19 years included in four statutory health insurance of the year 2021 were analysed. A deprivation index using data on the level of the ZIP code area was calculated. Analyses were carried out descriptively, using ordinary least squares (OLS) and geographically weighted regression (GWR).
Results The prevalence of mental and behavioural disorders in children and adolescents varied across ZIP code areas, with higher rates in the northern, southern, and eastern parts of the city. The results indicated that the use of services by male children and adolescents with a prevalent diagnosis of mental and behavioural disorders was higher in areas with a higher density of healthcare providers. However, prevalence was on the whole lower in areas with a higher density of healthcare providers. In addition, the density of health care providers was higher in the city centre with comparatively lower deprivation.
Conclusion These results indicate inadequate access to care for children and young people outside the city centre. However, due to the heterogeneity of the population in these areas, this study provides only preliminary insights. Data with a finer geographic resolution are needed for further research in order to analyse the association further.
Publication History
Article published online:
19 August 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag
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