Gender Differences in the Social Pathways Linking Neighborhood Disadvantage to Depressive Symptoms in Adults

Emma Bassett,Spencer Moore,Lawrence Kazembe

doi:10.1371/journal.pone.0076554

Abstract

Depression debilitates the lives of millions and is projected to be the second leading disease burden worldwide by 2020. At the population level, the causes of depression are found in the everyday social and physical environments in which people live. Research has shown that men and women often experience neighbourhood environments differently and that these variations are often reflected in health outcomes. The current study examines whether social and environmental correlates of depression are similar in men and women. This study examines whether (i) there are gender differences in the association between neighbourhood disadvantage and depressive symptoms, and (ii) dimensions of social capital and cohesion mediate these associations. Data come from the Montreal Neighbourhood Networks and Healthy Aging Study, which consists of a cluster stratified sample of Montreal census tracts (nct = 300) and individuals within those tracts (ni = 2707). Depressive symptoms and social capital were measured with a questionnaire. Neighbourhood disadvantage was measured at the census tract level using data from the 2006 Canada Census. Multilevel logistic regression stratified by gender and a three-step mediation analysis procedure were used. Final sample size for these analyses was 2574 adults. Depressive symptoms had a prevalence of 17.3% in the overall sample. Disadvantage was associated with depressive symptoms in women only (OR = 1.25, 95% CI = 1.01–1.55). Perceived neighbourhood cohesion was shown to mediate the association of disadvantage and depressive symptoms in women (ab = 0.02; 95% CI = 0.003–0.04, p<0.05). Other socio-relational variables, specifically generalized trust and trust in neighbours were associated with depression in women but did not act as mediating variables. Health promotion initiatives meant to combat depression may wish to consider gender differences in the design and implementation of neighbourhood or peer-based programs.

Highlights

Depression is a major health concern in countries around the world, and has a significant impact on the lives of millions of Canadians [1]
The current study investigated whether the potential social pathways linking neighbourhood disadvantage to depressive
The study assessed whether aspects of neighbourhood social cohesion and social capital were associated with depressive symptoms in women and men in the same way

Summary

Introduction

Depression is a major health concern in countries around the world, and has a significant impact on the lives of millions of Canadians [1]. Explanations of why neighbourhood environments may have different health effects on women and men include: (1) women and men perceive neighbourhoods differently; (2) women and men are exposed within neighbourhoods to different stressors and at varying degrees; and (3) women may be more vulnerable than men to certain aspects of the neighbourhood environment due to differences in social roles [7]. Despite such propositions, little research has examined whether characteristics of neighbourhood environments are more strongly associated with depressive symptoms in women than men. Given the generally higher rates of depressive symptoms in women, such knowledge might inform the design of neighbourhood-based interventions aiming to improve the mental health of women

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