Abstract
BackgroundUrbanization is steadily increasing worldwide. Previous research indicated a higher incidence of mental health problems in more urban areas, however, very little is known regarding potential mechanisms underlying this association. We examined whether urbanicity was associated with mental health problems in children directly, and indirectly via hypothalamic-pituitary-adrenal (HPA)-axis functioning.MethodsUtilizing data from two independent samples of children we examined the effects of current urbanicity (n = 306, ages seven to 12 years) and early childhood urbanicity (n = 141, followed from birth through age 7 years). Children’s mothers reported on their mental health problems and their family’s socioeconomic status. Salivary cortisol samples were collected during a psychosocial stress procedure to assess HPA axis reactivity to stress, and at home to assess basal HPA axis functioning. Neighborhood-level urbanicity and socioeconomic conditions were extracted from Statistics Netherlands. Path models were estimated using a bootstrapping procedure to detect indirect effects.ResultsWe found no evidence for a direct effect of urbanicity on mental health problems, nor were there indirect effects of urbanicity through HPA axis functioning. Furthermore, we did not find evidence for an effect of urbanicity on HPA axis functioning or effects of HPA axis functioning on mental health problems.ConclusionsPossibly, the effects of urbanicity on HPA axis functioning and mental health do not manifest until adolescence. An alternative explanation is a buffering effect of high family socioeconomic status as the majority of children were from families with an average or high socioeconomic status. Further studies remain necessary to conclude that urbanicity does not affect children’s mental health via HPA axis functioning.
Highlights
IntroductionLiving in urban compared to rural areas has been associated with an increased risk of mental health problems [1], and this may be so for children [2]
Preliminary analyses We confirmed that the psychosocial stress procedure had induced cortisol and perceived stress responses
We examined whether urbanicity was associated with mental health in children directly, and indirectly via HPA axis functioning
Summary
Living in urban compared to rural areas has been associated with an increased risk of mental health problems [1], and this may be so for children [2] This effect seems to be independent of other known risk factors such as sex, ethnicity, socioeconomic status (SES) and drug use [3]. Several studies showed that children who lived in a city were more likely to be diagnosed with a psychiatric disorder [6], including autism and attention deficit disorder [7, 8], and were more likely to exhibit psychotic symptoms [9] and behavioral and emotional problems [10] compared to children living in rural areas This association remained when controlling for other major risk factors for mental health problems such as SES, neighborhood social (2020) 8:12 cohesion, and parental symptoms of psychiatric disorders [9, 10]. Children growing up in a city may need to process social stress to a greater degree than their more rural counterparts
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