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Examining the factors associated with depression at the small area level in Ireland using spatial microsimulation techniques

Karyn Morrissey, Stephen Hynes, Graham Clarke, Cathal O’Donoghue


The World Health Organisation (WHO) predicts that, world-wide, depression will be the second largest source of burden of disease by 2020. It is currently estimated that approximately 300,000 Irish people experience depression. To date no research has been carried out on the small area incidence of depression in Ireland. Although research has looked at access levels to acute psychiatric hospitals for each electoral division (ED) in Ireland, there is currently no research on the accessibility of mental health services to individuals with depression. This paper aims to address this gap in the literature. First, a simple logistic regression model is used to identify the determinants of depression at the national level. Secondly, the spatial distribution of individuals with depression is estimated at the small area, ED level using a spatial microsimulation model. Finally, a spatial interaction model is used to analyse access to acute inpatient facilities at the national level and community-based facilities for individuals with depression at the sub-national level. The policy implications of these results are discussed in relation to both the health care literature and current Irish health care policy.

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