Table 4:
Socio-demographic predictors of any structural barrier among the subgroup with 12-month mental disorders who perceived a need for mental health care but did not access any, in the WMH Americas Surveys. Country effect vs. overall effect.
| Variable | Overall (n = 2650) | Argentina (n = 234) | Brazil (n = 431) | Colombia (n = 430) | Medellin, Colombia (n = 196) | Mexico (n = 352) | Peru (n = 203) | United States (n = 804) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| aORa | (95% CI) | aORa | (95% CI) | aORa | (95% CI) | aORa | (95% CI) | aORa | (95% CI) | aORa | (95% CI) | aORa | (95% CI) | aORa | (95% CI) | ||
| Sex | |||||||||||||||||
| Female | 1.7* | (1.2–2.3) | 1.3 | (0.6–3.0) | 1.0 | (0.6–1.7) | 0.7 | (0.4–1.2) | 1.1 | (0.5–2.7) | 1.2 | (0.7–2.4) | 0.8 | (0.3–2.1) | 1.0 | (0.7–1.5) | |
| Male | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | |
| χ21 (p-value) | 10.1* (0.001) | 0.4 (0.509) | 0.0 (0.956) | 2.1 (0.150) | 0.0 (0.832) | 0.5 (0.497) | 0.2 (0.685) | 0.0 (0.945) | |||||||||
| Age | |||||||||||||||||
| Age 18–34 | 1.0 | (0.4–2.5) | 0.4 | (0.1–2.0) | 0.7 | (0.2–3.4) | 0.3 | (0.0–2.8) | 1.6 | (0.5–5.5) | 0.4 | (0.1–1.9) | 0.7 | (0.3–1.9) | 25.4* | (3.4–188.6) | |
| Age 35–49 | 0.8 | (0.3–1.9) | 0.2* | (0.0–0.9) | 0.9 | (0.2–4.3) | 0.2 | (0.0–2.4) | 1.1 | (0.4–3.2) | 0.6 | (0.1–2.7) | 1.4 | (0.5–3.8) | 30.9* | (4.6–208.3) | |
| Age 50–64 | 0.9 | (0.3–2.2) | 0.8 | (0.2–3.3) | 0.6 | (0.1–3.3) | 0.3 | (0.0–3.2) | 1.0 | - | 0.4 | (0.1–2.0) | 1.0 | - | 18.8* | (2.4–149.8) | |
| Age ≥65 | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | |
| χ22–3 (p-value) | 2.9 (0.409) | 6.2 (0.104) | 1.5 (0.688) | 1.9 (0.588) | 0.8 (0.676) | 2.6 (0.458) | 4.3 (0.115) | 13.8* (0.003) | |||||||||
| Education | |||||||||||||||||
| Low | 1.5 | (0.9–2.5) | 0.8 | (0.3–2.8) | 0.8 | (0.3–2.3) | 1.5 | (0.6–4.0) | 2.0 | (0.3–15.9) | 0.7 | (0.3–1.6) | 0.7 | (0.2–3.0) | 1.0 | (0.5–2.1) | |
| Low average | 1.7* | (1.1–2.7) | 1.1 | (0.3–4.0) | 0.6 | (0.2–1.6) | 1.3 | (0.5–3.5) | 1.4 | (0.4–5.0) | 1.1 | (0.5–2.7) | 1.0 | (0.2–4.0) | 0.8 | (0.4–1.5) | |
| High average | 1.8* | (1.2–2.8) | 0.7 | (0.2–2.7) | 1.3 | (0.5–3.7) | 0.9 | (0.3–2.6) | 1.5 | (0.5–4.6) | 1.1 | (0.5–2.5) | 0.8 | (0.2–2.5) | 0.8 | (0.4–1.5) | |
| High | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | |
| χ23 (p-value) | 8.5* (0.036) | 0.6 (0.889) | 4.3 (0.230) | 1.3 (0.723) | 0.8 (0.856) | 1.8 (0.622) | 0.4 (0.948) | 1.0 (0.791) | |||||||||
| Marital status | |||||||||||||||||
| Married-cohabitating | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | |
| Previously married | 0.9 | (0.6–1.2) | 2.9* | (1.0–8.1) | 1.1 | (0.5–2.3) | 0.8 | (0.3–2.0) | 0.8 | (0.3–2.3) | 1.0 | (0.4–2.4) | 0.6 | (0.2–1.7) | 0.9 | (0.5–1.6) | |
| Never married | 1.0 | (0.7–1.3) | 1.6 | (0.6–3.8) | 0.6 | (0.3–1.3) | 1.1 | (0.6–2.1) | 0.8 | (0.4–1.8) | 1.3 | (0.6–2.6) | 1.5 | (0.6–3.7) | 0.6 | (0.4–1.1) | |
| χ22 (p-value) | 0.7 (0.714) | 4.3 (0.117) | 2.4 (0.303) | 0.5 (0.791) | 0.3 (0.841) | 0.5 (0.788) | 2.0 (0.367) | 2.7 (0.256) | |||||||||
| Income | |||||||||||||||||
| Low | 1.2 | (0.8–1.7) | 0.2* | (0.1–0.6) | 1.2 | (0.5–2.6) | 0.9 | (0.5–1.6) | 2.4 | (0.9–6.9) | 1.2 | (0.5–2.5) | 2.2 | (0.7–7.2) | 0.7 | (0.4–1.3) | |
| Low average | 1.1 | (0.7–1.6) | 0.1* | (0.0–0.5) | 1.7 | (0.7–4.2) | 1.2 | (0.5–3.3) | 1.9 | (0.4–8.6) | 1.3 | (0.6–2.8) | 2.2 | (0.9–5.2) | 0.7 | (0.3–1.4) | |
| High average | 0.9 | (0.6–1.4) | 0.2* | (0.1–0.8) | 0.9 | (0.4–2.0) | 0.9 | (0.4–2.0) | 2.4 | (0.6–9.4) | 0.8 | (0.4–1.8) | 3.6 | (0.9–14.1) | 0.8 | (0.4–1.5) | |
| High | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | |
| χ23 (p-value) | 2.8 (0.422) | 11.9* (0.008) | 2.0 (0.575) | 0.7 (0.868) | 3.0 (0.392) | 1.4 (0.700) | 4.4 (0.220) | 1.4 (0.696) | |||||||||
| Severity | |||||||||||||||||
| Severe | 2.5* | (1.7–3.6) | 1.8 | (0.7–4.8) | 0.9 | (0.4–1.8) | 1.0 | (0.4–2.3) | 1.7 | (0.5–5.8) | 0.7 | (0.3–1.4) | 0.5 | (0.2–1.4) | 1.0 | (0.6–1.8) | |
| Moderate | 1.7* | (1.2–2.4) | 1.2 | (0.4–3.3) | 0.8 | (0.4–1.7) | 0.9 | (0.4–1.8) | 3.5* | (1.1–11.2) | 0.7 | (0.3–1.3) | 0.6 | (0.3–1.3) | 0.8 | (0.5–1.4) | |
| Mild | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | 1.0 | - | |
| χ22 (p-value) | 21.4* (<0.001) | 1.7 (0.422) | 0.4 (0.810) | 0.2 (0.919) | 6.5* (0.038) | 1.6 (0.453) | 2.2 (0.327) | 1.3 (0.534) | |||||||||
Model Fit AIC = 1883.0
Data are given as adjusted odds ratios (95% confidence interval) unless otherwise indicated
Significant at p = .05, 2-sided test
Reference categories are denoted as 1.0 -; Age groups 50–64 and 65+ were collapsed for Peru and Medellin due to cells with zero-counts.
The degrees of freedom for each chi-square test is based upon the number of groups available in each main category
Note: each row shows a separate logistic regression model with any structural barrier as the outcome variable, controlling for the other predictor variables (rows), survey, and all predictor-by-survey interaction dummies. The second column shows the overall adjusted predictor variable effect; the survey columns show to what extent the survey-specific adjusted predictor variable effect deviates from the overall adjusted predictor variable effect. For example, the survey-specific effect for females (versus males) in Mexico can be obtained by multiplying the aOR = 1.6 (the overall effect) by the aOR = 1.3 (the country-specific deviation), i.e., aOR = 2.1
Models include controls for groups of 12-Month DSM-IV / WMH CIDI disorders (any anxiety, any mood, any substance, and any externalized)
Intermittent explosive disorder was not assessed in Mexico and Medellin, were coded as zero; Imputed variables for alcohol and drug dependence were used for Colombia, Mexico, Peru and the U.S.; Lifetime ADHD was used in all countries, and was coded as zero for those with age > 45 in Colombia, Mexico, Peru and the U.S.