Blues from the Neighborhood? Neighborhood Characteristics and Depression

Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, USA.
Epidemiologic Reviews (Impact Factor: 6.67). 09/2008; 30(1):101-17. DOI: 10.1093/epirev/mxn009
Source: PubMed


Unipolar major depression ranks among the leading contributors to the global burden of disease. Although established risk factors for depression include a variety of individual-level characteristics, neighborhood etiologic factors have been relatively understudied, with several such attributes (neighborhood socioeconomic status, physical conditions, services/amenities, social capital, social disorder) possessing plausible linkages to depression. Using the PubMed database (1966-2008) and the Social Sciences Citation Index database (1956-2008), the author undertook a systematic review of the published literature on the associations between these characteristics and depression in adults. Across studies, the evidence generally supports harmful effects of social disorder and, to a lesser extent, suggests protective effects for neighborhood socioeconomic status. Few investigations have explored the relations for neighborhood physical conditions, services/amenities, and social capital, and less consistently point to salutary effects. The unsupportive findings may be attributed to the lack of representative studies within and across societies or to methodological gaps, including lack of control for other neighborhood/non-neighborhood exposures and lack of implementation of more rigorous methodological approaches. Establishing mediating pathways and effect-modifying factors will vitally advance understanding of neighborhood effects on depression. Overall, addressing these gaps will help to identify what specific neighborhood features matter for depression, how, and for whom, and will contribute to curtailing the burden of disease associated with this major disorder.

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    • "Mair et al. (2008) found that, of 45 studies on neighborhoods and depression, 37 demonstrated significant neighborhood effects, even after controlling for individual-level factors such as age, race, gender, and indicators of socioeconomic status; in another review, Kim (2008) found that 11 of 22 studies examining neighborhood socioeconomic status showed that neighborhood conditions had significant effects on depression. Mechanisms directly linking neighborhood factors to mental health or depression often revolve around increased stress levels, limited access to or scant resources, disorder, violence, inadequate housing, and a lack of public access or green spaces, such as bike lanes and clean streets or sidewalks (e.g., Kim 2008; Mair et al. 2008; Taylor and Repetti 1997). Accumulating evidence also suggests that perceived disorder and/or dangerousness of the neighborhood increases depression, perhaps in part due to increased fear or mistrust among neighbors (e.g., Ross and Jang 2000; Ross and Mirowsky 2009), social isolation (e.g., Geis and Ross 1998; Ross and Mirowsky 2009), feelings of powerlessness (e.g., Aneshensel and Sucoff 1996; Geis and Ross 1998), or fear and anxiety amongst neighbors (e.g., Hill et al. 2005). "
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    ABSTRACT: This study examines the direct effects of neighborhood supportive mechanisms (e.g., collective efficacy, social cohesion, social networks) on depressive symptoms among females as well as their moderating effects on the impact of IPV on subsequent depressive symptoms. A multilevel, multivariate Rasch model was used with data from the Project on Human Development in Chicago Neighborhoods to assess the existence of IPV and later susceptibility of depressive symptoms among 2959 adult females in 80 neighborhoods. Results indicate that neighborhood collective efficacy, social cohesion, social interactions, and the number of friends and family in the neighborhood reduce the likelihood that females experience depressive symptoms. However, living in areas with high proportions of friends and relatives exacerbates the impact of IPV on females' subsequent depressive symptoms. The findings indicate that neighborhood supportive mechanisms impact interpersonal outcomes in both direct and moderating ways, although direct effects were more pronounced for depression than moderating effects. Future research should continue to examine the positive and potentially mitigating influences of neighborhoods in order to better understand for whom and under which circumstances violent relationships and mental health are influenced by contextual factors.
    American Journal of Community Psychology 09/2015; DOI:10.1007/s10464-015-9753-8 · 1.74 Impact Factor
    • "For example , an increased drift towards disadvantaged urban environments of people who have suffered a decline in mental health and perhaps an associated slide in social standing (Lapouse et al., 1956), or an outmigration of the more wealthy and healthy from larger conurbations to suburban areas (O'Reilly et al., 2001). No study to date has analysed all three hypotheses concurrently and, of late, studies have begun suggesting other factors which may be affecting health in urban areas including pollution, air traffic noise, social networks and the quality of the built environment (Galea et al., 2005; Kim, 2008). This aim of this paper is to determine if (i) urban residence is associated with an increased risk of suffering from common mood disorders such as anxiety and depression (as measured by uptake of anxiolytic and antidepressant medication), and (ii) to determine if this association is independent of psychosocial stressors, area disadvantage and selective migration. "
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    ABSTRACT: To determine if urban residence is associated with an increased risk of anxiety/depression independent of psychosocial stressors, concentrated disadvantage or selective migration between urban and rural areas, this population wide record-linkage study utilised data on receipt of prescription medication linked to area level indicators of conurbation and disadvantage. An urban/rural gradient in anxiolytic and antidepressant use was evident that was independent of variation in population composition. This gradient was most pronounced amongst disadvantaged areas. Migration into increasingly urban areas increased the likelihood of medication. These results suggest increasing conurbation is deleterious to mental health, especially amongst residents of deprived areas. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Health & Place 07/2015; 34. DOI:10.1016/j.healthplace.2015.05.003 · 2.81 Impact Factor
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    • "An emerging body of literature documents an association between low neighborhood socioeconomic status (NSES) and worse health across a broad array of outcomes beyond individual socioeconomic characteristics (Alegria et al., 2014; Chaix, 2009; Kim, 2008; Mair et al., 2008; Pickett and Pearl, 2001). In the past few years, this literature has begun to document neighborhood associations with allostatic load (AL), an indicator of cumulative biological risk (Bird et al., 2010; King et al., 2011; Merkin et al., 2009; Schulz et al., 2012; Stimpson et al., 2007; Theall et al., 2012; Wallace et al., 2013). "
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    ABSTRACT: Neighborhood context may influence health and health disparities. However, most studies have been constrained by cross-sectional designs that limit causal inference due to failing to establish temporal order of exposure and disease. We tested the impact of baseline neighborhood context (neighborhood socioeconomic status factor at the block-group level, and relative income of individuals compared to their neighbors) on allostatic load two years later. We leveraged data from the Boston Puerto Rican Health Study, a prospective cohort of aging Puerto Rican adults (aged 45-75 at baseline), with change in AL modeled between baseline and the 2nd wave of follow-up using two-level hierarchical linear regression models. Puerto Rican adults with higher income, relative to their neighbors, exhibited lower AL after two years, after adjusting for NSES, age, gender, individual-level SES, length of residence, and city. After additional control for baseline AL, this association was attenuated to marginal significance. We found no significant association of NSES with AL. Longitudinal designs are an important tool to understand how neighborhood contexts influence health and health disparities. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Health & Place 05/2015; 33. DOI:10.1016/j.healthplace.2015.02.001 · 2.81 Impact Factor
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