The association between residential area characteristics and mental health outcomes among men and women in Belgium

Complaints of depression and generalized anxiety were measured by means of the relevant subscales of the Symptoms Checklist 90-Revised. Multilevel models were estimated with PASW statistics 18, based on a unique dataset, constructed by merging data from the Belgian Health Interview Surveys from 2001 and 2004 with data from 264 municipalities derived from Statistics Belgium and the General Socio-Economic Survey.The results of this exploratory study indicate that the local unemployment rate is associated with complaints of depression among women.This study suggests that policy should approach the male and female population differently when implementing mental health prevention campaigns.The mental health epidemic contributes extensively to the global burden of disease. In middle- and high-income countries, depression is the primary cause of loss of health [1]. Due to the high prevalence of mental disorders, it is crucial to examine which factors determine mental health problems. Current research in Belgium concerning the determinants of mental wellbeing primarily draws attention to individual determinants. However, international empirical research has demonstrated that health outcomes differ according to the residential area in which a person lives. Studies in Great Britain [2-7], The Netherlands [8], Canada [9], Sweden [10] and the United States [11,12] showed that these differences can partly be attributed to contextual effects. This study will fill this research gap by studying the association between contextual factors and mental health complaints among the general Belgian population. To the best of our knowledge, only Lorant and colleagues [13] studied contextual influences on mental health in Belgium, but this among a selective population of migrants.A diverse set of socio-economic characteristics of the residential area has been suggested as affecting the mental health of its inhabitants [4,11,14-17]. The social conditions of an individual's neighborhood operat