Joan Damiens (DEMO, UCLouvain)
The right place. Investigating the relation between living environment and mental health in Belgium through administrative and health survey data
Housing conditions and environmental quality are a strong determinant in the social inequalities in health and mortality. However, the underlying mechanisms of this relation are still poorly understood, especially when it comes to the relation between the living environment, mental health and suicide risk. The objective of this research is to estimate the association between environmental conditions (defined by the housing conditions and the satisfaction over neighbourhood but also the relative housing quality, compared to the standards of the neighbourhood) and suicide risk in Belgium.
The study relies on the coupling of the Belgian 2001 Census, the National Register and the death certificates (2002-2006). Housing and neighbourhood quality scores are defined based on 17 indicators related to the objective housing comfort and the satisfaction over the amenities and the services in the close environment. Cox proportional hazard models were used to estimate the risk of suicide of the 25 to 69-year-old adults living in Belgium, according to the absolute housing quality score, the neighbourhood quality score and the relative housing quality, defined by the individuals’ housing quality compared to the proportion of very good quality housing within the statistical sector.
Results show a lower suicide risk for the population living in high-quality housing, compared to the population living in poorer housing conditions, for both men and women, after controlling for individual characteristics that include age, household composition, educational attainment and occupational status. . This relation might also depend on the social comparison between neighbours: living in a place that is comfortable, but not as comfortable as the neighbourhood standards, is associated with a higher suicide risk than fitting in the housing quality norm of the neighbourhood. No clear association was visible between the satisfaction over neighbourhood amenities or services and suicide risk.
This article confirms a negative association between housing conditions and mortality by suicide. While we highlight the importance to guarantee good housing quality and access to amenities and services, our results show the possible negative association between heterogeneity of housing quality in a territory and mental health. This presentation also integrates the use of Belgian health survey by interview data (2013, 2018) to estimate the relation between housing quality and other mental health outcomes, such as anxiety, depression and suicidal thoughts and behaviours.
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