Table 7.
Mediation of the effect of social determinants of health on substance-use through mental health
| Relationship a | Total effect | Direct effect (SE) |
p-value | Indirect effect (SE) | Confidence intervals b | Conclusion | |
|---|---|---|---|---|---|---|---|
| Lower bound | Upper bound | ||||||
| Housing—> Mental health—> Substance-use | − 0.21 | 0.12 (0.26) | 0.64 | − 0.33 (0.10) | 0.16 | 0.57 | Full mediation |
| Employment—> Mental health—> Substance-use | − 0.22 | − 0.32 (0.46) | 0.48 | 0.10 (0.13) | − 0.13 | 0.36 | No mediation |
| Financial—> Mental health—> Substance-use | 0.51 | 0.37 (0.24) | 0.12 | 0.15 (0.07) | 0.03 | 0.30 | Full mediation |
| Education—> Mental health—> Substance-use | 0.71 | − 0.19 (0.50) | 0.70 | 0.90 (0.14) | − 0.17 | 0.38 | No mediation |
| Domestic violence—> Mental health—> Substance-use | 1.81 | 1.24 (0.63) | 0.05 | 0.57 (0.23) | 0.21 | 1.10 | Partial mediation |
| Child-custody—> Mental health—> Substance-use | 0.54 | 0.36 (0.30) | 0.24 | 0.18 (0.10) | 0.01 | 0.39 | Full mediation |
| Social support—> Mental health—> Substance-use | 0.84 | 0.48 (0.27) | 0.07 | 0.36 (0.11) | 0.18 | 0.59 | Full mediation |
Bold: Significance was determined if the entire interval lies on one side of the null hypothesis value (i.e., 0). This indicates statistical significance at the chosen significance level (i.e., 95% confidence level)
SE = standard error
a Adjusted for admission year and age
b10,000 bootstrap samples were used for percentile confidence intervals