Mental health selection: common mental disorder and migration between multiple states of deprivation in a UK cohort

Giles Greene*, Andrea Gartner, Daniel Farewell, Lazlo Trefan, Alisha R. Davies, Mark A. Bellis, Shantini Paranjothy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
6 Downloads (Pure)


Objectives: To assess whether the direction of movement along the social gradient was associated with changes in mental health status. Design: Longitudinal record-linkage study using a multistate model. Setting: Caerphilly, Wales, UK between 2001 and 2015. Participants: The analytical sample included 10 892 (60.8% female) individuals aged 18?74 years. Primary and secondary outcome measures: Deprivation change at lower super output area level using the 2008 Welsh Index of Multiple Deprivation. Mental health was assessed in 2001 and 2008 using the Mental Health Inventory subscale of the short-form 36 V.2. Results: Mental health selection was shown whereby individuals with common mental health disorders were less likely to move to areas of lower deprivation but more likely to move to areas of greater deprivation. Conclusion: Poor mental health seems to drive health selection in a similar way to poor physical health. Therefore, funding targeted at areas of higher deprivation should consider the demand to be potentially higher as individuals with poor mental health may migrate into that area.
Original languageEnglish
Article number033238
Number of pages8
JournalBMJ Open
Issue number2
Early online date6 Feb 2020
Publication statusPublished - Feb 2020

Bibliographical note

Funding Funding for this work was received from Public Health Wales NHS Trust as part of a report on migration and health. Support for the report was also received from the National Centre for Population Health and Wellbeing Research (NCPHWR). The eCATALYsT multiagency dataset and the baseline survey was supported by the Wales Office of Research and Development (SCC99/1/105 and R00/1/017). The follow-up survey was supported by a Welsh Assembly Government/Medical Research Council Health Research Partnership Award (H07-3-030), and the electronic cohort is supported by a National Institute for Social Care and Health Research Welsh Assembly Government Translational Health Research Platform Award (TPR08-020).

Data availability statement Data may be obtained from a third party and are not publicly available. The electronic cohort is securely stored and maintained on the Secure Anonymised Information Linkage (SAIL) databank at Swansea University Medical School. The authors welcome general enquiries and ideas for new collaborations. Readers with an interest in further details should contact Professor Shantini Paranjothy, Principal Investigator.


  • depression & mood disorders
  • epidemiology
  • public health


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