Association Of Neighborhood Built And Social Environment And Depressive Symptoms Among Middle Aged And Older Adults

Abstract

Current research suggests that neighborhoods with few socioeconomic resources and unsafe conditions impose constant stress on the inhabitants, which can lead to increased risks for poor mental health conditions such as depression. PURPOSE: To examine whether neighborhood walkability, socioeconomic status, and residents' perceptions of their neighborhood environment were associated with depressive symptoms among middle aged and older adults. METHODS: The study used a cross-sectional, multilevel design involving neighborhoods as the primary sampling unit and residents as the secondary unit. A Geographic Information System-based measure of neighborhood walkability was constructed in 120 randomly selected neighborhoods in Portland, Oregon, from which 1145 adult residents 51-76 years of age completed a neighborhood environment and health survey. Depressive symptomology defined by the Center for Epidemiologic Studies Depression Scale (CES-D) with a cut-off score of ≥10. Multilevel logistic regression analyses were used to examine level-specific and cross-level associations between neighborhood-level measures of walkability and socioeconomic status and residents' perceptions of neighborhood safety, aesthetics, and social cohesion, and depressive symptoms. RESULTS: High walkability and socioeconomically advantaged neighborhoods were associated with a reduced likelihood of depressive symptoms. However, residents of low-walkability neighborhoods whose perceived their neighborhood as safe and socially cohesive and those in socioeconomically disadvantaged neighborhoods who perceived their neighborhoods as safe and having good aesthetics were also less likely to have depressive symptoms. CONCLUSIONS: These findings provide new evidence of the importance of both the independent and joint influences of urban form and people's perceptions of the built and social environment to the development of depressive symptomatology. Promoting neighborhood built and social environments that are safe, pleasing, and cohesive may be an important intervention for enhancing residents' health and reducing the likelihood of developing depressive symptoms. Supported by NIH Grant R01 ES014252