Neighborhood Contextual Influences on Depressive Symptoms in the Elderly

Abstract

To understand whether neighborhood contexts contribute to the onset or maintenance of mental health problems independently of individual characteristics requires the use of multilevel study designs and analytical strategies. This study used a multilevel analytical framework to examine the relation between neighborhood context and risk of depressive symptoms, using data from the New Haven component of the Established Populations for Epidemiologic Studies of the Elderly, a community-based sample of noninstitutionalized men and women aged 65 years or older and living in the city of New Haven, Connecticut, in 1982. Neighborhoods were characterized by census-based characteristics and also by measures of the neighborhood service environment using data abstracted from the New Haven telephone book Yellow Pages. Living in a poor neighborhood was associated with higher levels of depressive symptoms in older adults, above and beyond individual vulnerabilities. In addition, the presence of more elderly people in the neighborhood was associated with better mental health among older adults. The authors found no evidence that access to services hypothesized to promote social engagement, to provide health services, or to affect the reputation of a neighborhood explained (i.e., mediated) neighborhood variations in depressive symptoms.

Neighbourhood socioeconomic indicators and depressive symptoms in the Czech Republic: a population based study

“…This suggests that our individual-level indicators included the important ones. Our principal findings on area effects are consistent with most previous studies [38][39][40] , although two studies have reported effects of neighbourhood SES on depressive symptoms which persisted in models controlling for individual-level SES 41,42 . It has been suggested that the effects of area-level variables may reflect weaknesses of individual-level model 43 , such as missing important variables.…”

Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses

“…Rather than simply measuring individual perceptions of others' stigma, we suggest that a true measure of public stigma should contextualize the aggregate environment of individual self-beliefs about stigma at a specific time and in a specific place. As scholars have suggested in a wide-ranging literature on neighborhood and school contextual effects, individual characteristics and aggregated individual characteristics at the group level may each have their own influence on social processes and outcomes (Harding 2003;Jencks and Mayer, 1990;Kubzansky et al 2005;Lauen and Gaddis 2013;Sampson, Morenoff, and GannonRowley 2002;Sharkey et al, 2012). In fact, recent work has highlighted the link between community-level prejudice and health outcomes (Blair and Brondolo 2017;Orchard and Price 2017).…”

Concordance of Commercial Data Sources for Neighborhood-Effects Studies

“…[5][6][7][8] Building on this work, the neighborhood service environment, as measured by availability of various types of businesses and organizations hypothesized as favorable or unfavorable to health, has been examined for its association with health outcomes. 9,10 Researchers are beginning to assess the quality of secondary data sources with business information, [11][12][13][14] given that these data sources are increasingly being used in research with some expressing concerns about the accuracy and completeness of these data sources. 5,[15][16][17][18] Information on the completeness and accuracy of multiple data sources for ascertaining local businesses is important not only to health researchers, but also to community organizations, policy-makers, transportation planners, and others who seek to map local businesses and resources.…”