Abstract
BackgroundCross-sectional studies have found associations between neighbourhood environments and adolescent mental health, but the few longitudinal studies mainly focused on single exposure-based analyses and rarely assessed the mental health associations with environmental changes. ObjectivesWe assessed longitudinal within- and between-person associations of multiple neighbourhood time-varying physical and social environmental exposures with externalising and internalising problems throughout adolescence. MethodsWe used four waves of TRAILS (Tracking Adolescents’ Individual Lives Survey) data on self-reported externalising and internalising problems at ages 11, 13, 16, and 19 among 2,135 adolescents in the Netherlands. We measured residence-based time-varying environmental exposures, including green space, air pollution (fine particulate matter (PM2.5)), noise, deprivation, and social fragmentation. We fitted random-effect within-between regression models to assess the environment-mental health associations. ResultsAt the within-person level, an interquartile range (IQR) increase in PM2.5 was associated with a 0.056 IQR (95% CI: 0.014, 0.099) increase in externalising problems, while an IQR social fragmentation increase was associated with a 0.010 IQR (95% CI: −0.020, −0.001) decrease in externalising problems. Stratification revealed that the association with PM2.5 was significant only for movers, whereas the association with social fragmentation remained only for non-movers. At the between-person level, an IQR higher noise was associated with a 0.100 IQR (95% CI: 0.031, 0.169) more externalising problems, while higher deprivation (β = 0.080; 95% CI: 0.022, 0.138) and lower fragmentation (β = -0.073; 95% CI: −0.128, −0.018) were associated with more internalising problems. We also observed positive between-person associations between PM2.5, noise, and internalising problems, but both associations were unstable due to the high PM2.5-noise correlation. Further, we observed a non-linear between-person PM2.5-externalising problems association turning positive when PM2.5 > 15 µg/m3. Null associations were found for green space. ConclusionOur findings suggested that air pollution, noise, and neighbourhood deprivation are risk factors for adolescent mental health. Not only exposure levels but also exposure changes matter for adolescent mental health.
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