Associations between residence at birth and XXXX : a spatial analysis of retrospective cohort data.

@entity1032 @entity162 @entity308 @entity146 @entity1005
BACKGROUND: Mental health disorders impact approximately one in four US adults. While their causes are likely multifactorial, prior research has linked the risk of certain @entity146 to prenatal and early childhood environmental exposures, motivating a spatial analysis to determine whether risk varies by birth location. METHODS: We investigated the spatial associations between residence at birth and odds of @entity308 , @entity162 , and @entity1005 ( @entity1005 ) in a retrospective cohort (Cape Cod, Massachusetts, 1969-1983) using generalized additive models to simultaneously smooth location and adjust for confounders. Birth location served as a surrogate for prenatal exposure to the combination of social and environmental factors related to the development of @entity1032 . We predicted crude and adjusted odds ratios (aOR) for each outcome across the study area. The results were mapped to identify areas of increased risk. RESULTS: We observed spatial variation in the crude odds ratios of @entity308 that was still present even after accounting for spatial confounding due to geographic differences in the distribution of known risk factors (aOR range: 0.61-3.07, P   =   0.03). Similar geographic patterns were seen for the crude odds of @entity1005 ; however, these patterns were no longer present in the adjusted analysis (aOR range: 0.49-1.36, P   =   0.79), with family history of @entity1032 most notably influencing the geographic patterns. Analyses of the odds of @entity162 did not show any meaningful spatial variation (aOR range: 0.58-1.17, P   =   0.82). CONCLUSION: Spatial associations exist between residence at birth and odds of @entity1005 and @entity308 , but much of this variation can be explained by the geographic distributions of available risk factors. However, these risk factors did not account for all the variation observed with @entity308 , suggesting that other social and environmental factors within our study area need further investigation.
