Urban built environment and depression: a multilevel analysis

Study objective: To assess the relations between characteristics of the neighbourhood internal and external built environment and past six month and lifetime depression. Design and setting: Depression and sociodemographic information were assessed in a cross sectional survey of residents of New York City (NYC). All respondents were geocoded to neighbourhood of residence. Data on the quality of the built environment in 59 NYC neighbourhoods were collected from the United Status census, the New York City housing and vacancy survey, and the fiscal 2002 New York City mayor’s management report. Main results: Among 1355 respondents, residence in neighbourhoods characterised by a poor quality built environment was associated with greater individual likelihood of past six month and lifetime depression in multilevel models adjusting for individual age, race/ethnicity, sex, and income and for neighbourhood level income. In adjusted models, persons living in neighbourhoods characterised by poorer features of the built environment were 29%–58% more likely to report past six month depression and 36%–64% more likely to report lifetime depression than respondents living in neighbourhoods characterised by better features of the built environment. Conclusions: Living in neighbourhoods characterised by a poor quality built environment is associated with a greater likelihood of depression. Future prospective work designed to assess potential mechanisms underlying these associations may guide public health and urban planning efforts aimed at improving population mental health.

[1]  Allen Dearry,et al.  Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health. , 2003, American journal of public health.

[2]  W. A. White.  The Geographical Distribution Of Insanity In The United States , 1903 .

[3]  Nicholas Freudenberg,et al.  Cities and population health , 2004, Social Science & Medicine.

[4]  B C Amick,et al.  Relationship of job strain and iso-strain to health status in a cohort of women in the United States. , 1998, Scandinavian journal of work, environment & health.

[5]  Sandro Galea,et al.  Trends of probable post-traumatic stress disorder in New York City after the September 11 terrorist attacks. , 2003, American journal of epidemiology.

[6]  S. Messner,et al.  A study of homicides in Manhattan, 1981. , 1986, American journal of public health.

[7]  S. Galea,et al.  Income distribution and risk of fatal drug overdose in New York City neighborhoods. , 2003, Drug and alcohol dependence.

[8]  M. Woodbury,et al.  Psychiatric Disorders: A Rural/Urban Comparison , 1985 .

[9]  H. Merskey.  The Sociology of Mental Disorders , 1968, Mental Health.

[10]  S. Galea,et al.  Cities and the Health of the Public , 2006 .

[11]  H. Resnick,et al.  Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. , 2003, Journal of consulting and clinical psychology.

[12]  S. Raudenbush,et al.  Neighborhoods and violent crime: a multilevel study of collective efficacy. , 1997, Science.

[13]  M. Opler,et al.  MENTAL HEALTH IN THE METROPOLIS. , 1965, International journal of psychiatry.

[14]  M. Lieberman,et al.  The stress process. , 1981, Journal of health and social behavior.

[15]  J. Wildgen,et al.  "Broken windows" and the risk of gonorrhea. , 2000, American journal of public health.

[16]  S. Galea,et al.  Psychiatric Medication Use Among Manhattan Residents Following the World Trade Center Disaster , 2003, Journal of traumatic stress.

[17]  M. Elliott,et al.  The stress process in neighborhood context. , 2000, Health & place.

[18]  S. Galea,et al.  Urban health: evidence, challenges, and directions. , 2005, Annual review of public health.

[19]  S. Robert.  SOCIOECONOMIC POSITION AND HEALTH: The Independent Contribution of Community Socioeconomic Context1 , 1999 .

[20]  E. Silver,et al.  Neighborhood structural characteristics and mental disorder: Faris and Dunham revisited. , 2002, Social science & medicine.

[21]  E. Susser,et al.  Mental Health in the City , 2006 .

[22]  A. Leon,et al.  Poverty and fatal accidental drug overdoses of cocaine and opiates in New York City: an ecological study. , 1997, The American journal of drug and alcohol abuse.

[23]  J. Hanley,et al.  Statistical analysis of correlated data using generalized estimating equations: an orientation. , 2003, American journal of epidemiology.

[24]  C. Bulpitt,et al.  Local area deprivation and urban-rural differences in anxiety and depression among people older than 75 years in Britain. , 2004, American journal of public health.

[25]  Angelo J. Kinicki,et al.  A Longitudinal Study of a Multivariate Model of the Stress Process Using Structural Equations Modeling , 1995 .

[26]  R. Kessler,et al.  The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. , 1994, The American journal of psychiatry.

[27]  M. Northridge,et al.  A joint urban planning and public health framework: contributions to health impact assessment. , 2003, American journal of public health.

[28]  D. Phillips.  The influence of suggestion on suicide: substantive and theoretical implications of the Werther effect. , 1974, American sociological review.

[29]  Bob Erens,et al.  Mental health and the built environment: cross-sectional survey of individual and contextual risk factors for depression. , 2002, The British journal of psychiatry : the journal of mental science.

[30]  J. van os,et al.  Shared social environment and psychiatric disorder: a multilevel analysis of individual and ecological effects , 1998, Social Psychiatry and Psychiatric Epidemiology.

[31]  S. Galea,et al.  Mental health service and medication use in New York City after the September 11, 2001, terrorist attack. , 2004, Psychiatric services.

[32]  K. Pickett,et al.  Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review , 2001, Journal of epidemiology and community health.

[33]  W. Avison,et al.  Asian immigrants and the stress process: a study of Koreans in Canada. , 1996, Journal of health and social behavior.

[34]  A. Frei,et al.  The Werther effect and assisted suicide. , 2003, Suicide & life-threatening behavior.

[35]  R. D'Agostino,et al.  Job strain and health-related quality of life in a national sample. , 1994, American journal of public health.

[36]  J. Os,et al.  Neighbourhood level and individual level SES effects on child problem behaviour: a multilevel analysis , 2001, Journal of epidemiology and community health.

[37]  G. Evans.  The built environment and mental health , 2003, Journal of Urban Health.

[38]  J. Brooks-Gunn,et al.  Moving to opportunity: an experimental study of neighborhood effects on mental health. , 2003, American journal of public health.

[39]  R. Kessler,et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. , 1994, Archives of general psychiatry.

[40]  R. Faris,et al.  Mental Disorders in Urban Areas: An Ecological Study of Schizophrenia and Other Psychoses , 1939 .

[41]  S. Reijneveld,et al.  The impact of individual and area characteristics on urban socioeconomic differences in health and smoking. , 1998, International journal of epidemiology.

[42]  M. Gallant,et al.  The Stress Process among Dementia Spouse Caregivers , 1998 .

[43]  R. Schulz,et al.  Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study. , 2000, Psychology and aging.

[44]  Carl A Latkin,et al.  Stressful neighborhoods and depression: a prospective study of the impact of neighborhood disorder. , 2003, Journal of health and social behavior.

[45]  K Nakamura,et al.  Urban residential environments and senior citizens’ longevity in megacity areas: the importance of walkable green spaces , 2002, Journal of epidemiology and community health.