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Related Factors of Depression according to Individual Attributes and Regional Environment: Using Multi-Level Analysis

보건행정학회지 2020년 30권 3호 p.355 ~ 365
문석준, 이가람, 남은우,
소속 상세정보
문석준 ( Moon Seok-Jun ) - Yonsei University Graduate School Department of Health Administration
이가람 ( Lee Ga-Ram ) - Yonsei University College of Science Technology Department of Information Statistics
남은우 ( Nam Eun-Woo ) - Yonsei University Graduate School Department of Health Administration

Abstract


Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status.

Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels.

Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms. The comparison of area under the curve showed that individual factors had a greater influence than regional factors.

Conclusion: This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.

키워드

Multilevel analysis; Depression; Community care; Social prescription; Community health survey; ROC curve

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