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

ABSTRACT 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.

8 Reads
    • "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. "
    [Show abstract] [Hide abstract]
    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
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    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
  • Source
    • "Downloaded from may be accentuated among older Latino adults as a result of a combination of factors—for example, reduced physical and cognitive functioning, languagerelated barriers, decreased comfort and ability to drive, diminishing contact with social network—all of which can lead to greater dependence on the services and amenities offered within the immediate residential neighborhood (Kawachi & Berkman, 2003; Walters et al., 2004). Both objective (e.g., census tract data and outside observer ratings) and subjective environmental measures (i.e., individual perceptions) of neighborhood problems have been linked to elevated depressive symptoms (Kim, 2008; Mair, Diez Roux, & Galea, 2008; Paczkowski & Galea, 2010). Although there is debate as to the most effective means of assessing neighborhood indicators, perceptions of the neighborhood are thought to be more proximal to individual mental health outcomes as they have been found to mediate the relationship between objectively measured neighborhood indicators and psychological well-being (Evans-Polce, Hulbert, & Latkin, 2013; Ross & Jang, 2000). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Evaluate the cross-sectional and longitudinal association between perceived walkability-related neighborhood characteristics (e.g., traffic safety) and depressive symptoms among community-dwelling older Latino adults. Method: We used baseline, 12-month, and 24-month in-person interview data collected from Latinos aged ≥ 60 years participating in an exercise intervention at 27 senior centers (N = 570). Results: In cross-sectional analyses, lower perceived neighborhood crime, indicative of greater neighborhood walkability, was associated with a lower odds of elevated symptoms of depression (odds ratio [OR] = 0.90; 95% confidence interval [CI] = [0.82, 0.996]; p = .04) after adjusting for demographic characteristics, linguistic acculturation, and medical comorbidities. Associations between Neighborhood Environment Walkability scales and incident depressive symptoms at 12- and/or 24-months were not statistically significant, but the point estimate for crime safety was consistent with cross-sectional findings (OR = 0.83; 95% CI = [0.64, 1.07]; p = .16), suggesting a protective effect for lower perceived neighborhood crime. Discussion: Lower perceived neighborhood crime is associated with reduced presence of elevated symptoms of depression in older Latinos.
    Journal of Aging and Health 10/2014; 27(3). DOI:10.1177/0898264314553211 · 1.56 Impact Factor
Show more


8 Reads
Available from