Health Effects from Urban Stress in Women in Mexico City

Abstract

BACKGROUND AND AIM: Individuals in urban neighborhoods often face disproportionately higher levels of environmental and social stressors; however, the health effects from urban stressors remains poorly understood. We studied the association between urban stress and symptoms of depression, fatigue, and sleep disruption in a cohort of women in Mexico City. METHODS: Participants included 343 women from the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) birth cohort in Mexico City. Women were administered the urban stress scale, where they were asked to rate their annoyance on select urban situations that city-dwellers face, such as unhealthy air, traffic, noise, lack of green space, and aggression. Six different constructs were summarized to create an overall continuous index and this was dichotomized at the median. Symptoms of depression were assessed at the same study visit using the Edinburgh Depression Scale; the NIH toolbox was used to assess fatigue and sleep disruption. Linear regression models were used to estimate the association with continuous symptoms comparing women with high urban stress to those with lower levels. Models were adjusted for socioeconomic status, education, age, body mass index, and social support. RESULTS:High urban stress was associated with higher depressive symptoms (β: 1.50; 95% CI: 0.34, 2.65), fatigue (β: 2.18; 95% CI: 0.65, 3.71), and sleep disruption (β: 2.01; 95% CI: 0.45, 3.58). Associations were strongest among women who were highly annoyed by environmental concerns, including unhealthy air and lack of green space. CONCLUSIONS:Urban stress plays an important role in women’s psychological and physical health, highlighting the importance of including these measures in environmental health studies in urban settings. KEYWORDS: built environment, environmental justice, female, mental health outcomes, socio-economic factors, non-chemical stressors