Abstract
Objectives Little is understood about associations between neighborhood characteristics and depression, a cardiovascular disease (CVD) risk factor, in diverse populations. We examined relationships between perceived/objective neighborhood characteristics, depression, and CVD markers within the Washington, DC CV Health/Needs Assessment, an evaluation among predominantly African-American (AA) adults in resource-limited DC communities. Method Factor analysis of overall neighborhood environment perception (NEP) identified three NEP sub-scores:1) violence; 2) physical/social environment; 3) social cohesion (higher score = more favorable perception). Objective neighborhood characteristics were measured by geospatially-derived scores of walkability, transportation, and crime. Depression was defined by the revised Center for Epidemiologic Studies Depression Scale (CESD-R). We used linear-regression modeling to examine neighborhood measures and CESD-R associations. To investigate a subsequent connection with CVD risk, we examined relationships between CESD-R and CVD-associated cytokines in a population subset. Results Participants (N = 99; mean age = 59.06; 99% AA) had a mean CESD-R score = 5.8(SD = 8.88). In adjusted models, CESD-R scores decreased by 0.20 units (p = 0.01) for every overall NEP unit-increase. Perceived physical/social environment (β = −0.34, p = 0.04) and social cohesion (β = −0.82, p = 0.01) were related to CESD-R while perceived violence was not (β = −0.28, p = 0.1). Of objective neighborhood environment measures (i.e. walk, transit, bike, personal crime, and property crime scores), only property crime score was associated with depression (β = 4.99, p < 0.03). In population subset (n = 42), higher CESD-R associated with higher IL-1β (β = 21.25, p < 0.01) and IL-18 (β = 0.006, p = 0.01). Conclusion Favorable neighborhood perceptions are related to lower depressive symptoms in a predominantly AA cohort from Washington, DC resource-limited communities. Neighborhood perceptions appear to be strongly associated with depressive symptoms compared to objective characteristics. Increasing CESD-R scores were related to higher pro-inflammatory markers. Improving neighborhood perceptions may be beneficial to psychological well-being and CV health for urban minority residents.
Highlights
Depression is projected to be one of the leading causes of disability worldwide by 2030 (Mathers & Loncar, 2005)
People with depression have a 50% higher risk of cardiovascular disease (DE Hert et al, 2011). Data that explores these relationships among Black populations are scant; data conducted on African American samples show that the risk of cardiovascular disease as a result of depression to be between 30% and 59% compared to those who do not have depression (Copeland et al, 2017; O’Brien et al, 2015)
In models adjusting for household income, Neighborhood Deprivation Index (NDI), BMI, and ASCVD risk score, better overall neighborhood perceptions were related to a 0.20 unit decrease in depressive symptom scores (Total Perception Score: β= −0.19 p = 0.01)
Summary
Depression is projected to be one of the leading causes of disability worldwide by 2030 (Mathers & Loncar, 2005). In 2016, roughly 5% of African American adults indicated that they had experienced a major depressive episode within the last year, compared to 7.4% of white adults (Health, 2017). People with depression have a 50% higher risk of cardiovascular disease (DE Hert et al, 2011). Data that explores these relationships among Black populations are scant; data conducted on African American samples show that the risk of cardiovascular disease as a result of depression to be between 30% and 59% compared to those who do not have depression (Copeland et al, 2017; O’Brien et al, 2015).
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