Built Environment and Depression in Low-Income African Americans and Whites

Abstract

Introduction Urban environments are associated with a higher risk of adverse mental health outcomes; however, it is unclear which specific components of the urban environment drive these associations. Methods Using data collected in 2002–2009 from 73,225 low-income, racially diverse individuals across the Southeastern U.S., analyses evaluated the cross-sectional relationship between a walkability index and depression. Walkability was calculated from population density, street connectivity, and destination count in the 1,200-meter area around participants’ homes, and depression was measured using the Center for Epidemiologic Studies Depression Scale for depression symptomatology and questionnaire responses regarding doctor-diagnosed depression and antidepressant use. Data were analyzed in 2015. Results Participants living in neighborhoods with the highest walkability index had 6% higher odds of moderate or greater depression symptoms (score ≥15, 95% CI=0.99, 1.14), 28% higher odds of doctor-diagnosed depression (95% CI=1.20, 1.36), and 16% higher odds of current antidepressant use (95% CI=1.08, 1.25) compared with those in the lowest walkability index. Higher walkability was associated with higher odds of depression symptoms only in the most deprived neighborhoods, whereas walkability was associated with lower odds of depression symptoms in the least deprived neighborhoods. Conclusions Living in a more walkable neighborhood was associated with modestly higher levels of doctor-diagnosed depression and antidepressant use, and walkability was associated with greater depression symptoms in neighborhoods with higher deprivation. Although dense urban environments may provide opportunities for physical activity, they may also increase exposure to noise, air pollution, and social stressors that could increase levels of depression.

Socioeconomic, Environmental, and Behavioral Determinants of Leprosy in Kediri, East Java

“…The relationship between family income and dwelling density The result of this study showed that there was a relationship between family income and leprosy through dwelling density. This study was supported by James et al (2017) who stated that the density of mixed land use and road connectivity has generally been associated with family income. The higher the income of a person, then they would try to improve their quality of life including the dwelling.…”

“…Humidity as a whole is the moisture in the area. After being exposured by sunlight, it decreased the humidity of the room (James et al, 2017).…”

“…Qualitative studies report-ed that the dwelling was considered as an important determinant of health. Environmental quality such as dense dwelling would lead to the transmission of transmitted diseases (James et al, 2017). 9.…”

Comparisons of depression, anxiety, well-being, and perceptions of the built environment amongst adults seeking social, intermediate and market-rent accommodation in the former London Olympic Athletes’ Village

“…Negative perceptions of the neighbourhood (e.g. perceived level of accessibility to greenspace, more crime, feeling unsafe, less walkability) have been found to be associated with depression, anxiety ( Ellaway et al, 2009 , Lorenc et al, 2012 , James et al, 2017 ), and both physiological and self-reported measures of stress ( Abraham et al, 2010 ). Positive perceptions are associated with higher rates of physical activity which, in turn, may reduce depression and cardiovascular risk with potential benefits for both physical and mental health ( Shanahan et al, 2016 ).…”

“…Positive perceptions are associated with higher rates of physical activity which, in turn, may reduce depression and cardiovascular risk with potential benefits for both physical and mental health ( Shanahan et al, 2016 ). However, effects of the built environment on mental health and well-being may be moderated by socio-economic status ( James et al, 2017 ).…”