Johnell K, Merlo J, Lynch J, Blennow G. Neighborhood social participation and women's use of anxiolytic-hypnotic drugs: a multilevel analysis. Journal of Epidemiology and Community Health. 2004;58:59-64.
The investigators in this Swedish study sought to identify and quantify a hypothesized collective effect of the neighborhood on individual use of anxiolytic-hypnotic drugs (AHDs), which are commonly prescribed to address anxiety or sleep-related disorders. The investigators analyzed cross-sectional data from women living in 95 neighborhoods in Malmö, Sweden. A key study finding was that both individual and neighborhood social participation were independently associated with AHD use. The researchers defined individual social participation as possible involvement in 13 formal or informal activities (such as participation in meetings of organizations; attending theater/cinema, arts exhibitions, church, or sports event; writing a letter to the editor of a newspaper/journal; and attending large gatherings of relatives or private party) during past 12 months. Items were summed, and participants involved in three or fewer activities were classified as having "low social participation." The researchers assessed neighborhood social participation by determining the proportion of persons in the neighborhood classified as having individual "low social participation."
A low level of neighborhood social participation was associated with higher probability of AHD use independent of individual age, low social participation, low educational level, and living alone. This association was reduced after accounting for individual disability pension, low self-rated health, stress, and medication for somatic disorders. The researchers found that overall, 1.7 percent of total individual differences in the propensity for using AHD were explained by the neighborhood-level social participation. They concluded that neighborhood level of social participation seemed to affect individual use of AHD, possibly through individual characteristics.
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