Abstract
We evaluated associations of community types and features with new-onset internalizing disorders among Pennsylvania adolescents to identify the location and scale of risk. Using a nested case-control study, we drew subjects from electronic health records 2008–2016, requiring cases (n = 7974) to have two medication orders or diagnoses indicating an internalizing disorder; controls (n = 31,895) were frequency-matched. Subjects were assigned to three community classifications: townships, boroughs, city census tracts; urbanized areas, urban clusters, rural areas; and a combination. Using logistic regression with generalized estimating equations, we found that compared to rural-townships, the highest odds were in urban cluster-city census tracts (odds ratio, 95% confidence interval: 1.78, 1.41–2.26); lowest in urbanized area-city census tracts (0.85, 0.74–0.97). Higher community socioeconomic deprivation was associated with increased odds in urban clusters (1.21, 1.00–1.48) and higher greenness with decreased odds in urban clusters (0.73, 0.62–0.86).
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
