Individual mental health, life course events and dynamic neighbourhood change during the transition to adulthood

How long-term changes in neighborhood and school racial composition shape children's behavior problems

Relatively few neighborhood-focused studies explicitly model the relationship between neighborhood change- i.e., racial change within a neighborhood-and individual mental health, instead focusing on the current composition of the neighborhood or on the outcomes of individuals that switch neighborhood contexts via moves. Further, while neighborhoods and schools are interconnected, researchers tend to focus on only one of these contexts in their work. Combining family and student data from the Panel Study of Income Dynamics (PSID) with multiple waves of neighborhood and school administrative data, our study extends current scholarship in this area by explicitly focusing on the relationship between exposure to neighborhood and school racial change-i.e., change occurring within the neighborhood or school in the prior decade-and the behavior problems of current students. We further analyze how associations vary: 1) by student race; 2) between newcomers to the neighborhood and those that lived in the neighborhood as it underwent demographic change; 3) and in neighborhoods with higher proportions of same-race residents. Our findings suggest that the relationship between local neighborhood contexts and the behavioral problems of children is nuanced and depends on the racial trajectories-change or stability-of neighborhoods, schools, and the interaction of both. Compared to longer-term residents, White newcomers tended to have more behavioral problems across racially changing and stable neighborhoods alike, regardless of the racial trajectories observed in the local school. Our results align with past work documenting the protective effect of same-race peers for Black children. Conversely, we find White students exhibit greater behavioral problems in settings with very high proportions of same-race peers, particularly in neighborhoods and schools that are simultaneously becoming increasingly racially isolated.

The health implications of neighborhood networks based on daily mobility in US cities

A large body of research has been dedicated to understanding the neighborhood conditions that impact health, which outcomes are affected, and how these associations vary by demographic and socioeconomic neighborhood and individual characteristics. This literature has focused mostly on the neighborhoods in which individuals reside, thus failing to recognize that residents across race/ethnicity and class spend a non-trivial amount of their time in neighborhoods far from their residential settings. To address this gap, we use mobile phone data from the company SafeGraph to compare racial inequality in neighborhood socioeconomic advantage exposure across three scales: the neighborhoods that residents live in, their adjacent neighborhoods, and the neighborhoods that they regularly visit. We found that the socioeconomic advantage levels in neighborhood networks differ from the levels at the residential and adjacent scales across all ethnoracial neighborhoods. Furthermore, socioeconomic advantage at the network level is associated with diabetes and hypertension prevalence above and beyond its impact at the residential and adjacent levels. We also find ethnoracial differences in these associations, with greater beneficial consequences of network socioeconomic advantage exposure on hypertension and diabetes for white neighborhoods. Future social determinants of health research needs to reconceptualize exposure to include the larger neighborhood network that a community is embedded in based on where their residents travel to and from.

Association between trajectories of the neighborhood social exposome and mental health in late adolescence: A FinnTwin12 cohort study

BACKGROUND

Adolescent mental health problems impose a significant burden. Exploring evolving social environments could enhance comprehension of their impact on mental health. We aimed to depict the trajectories of the neighborhood social exposome from middle to late adolescence and assess the intricate relationship between them and late adolescent mental health.

METHODS

Participants (n = 3965) from the FinnTwin12 cohort with completed questionnaires at age 17 were used. Nine mental health measures were assessed. The social exposome comprised 28 neighborhood social indicators. Trajectories of these indicators from ages 12 to 17 were summarized via latent growth curve modeling into growth factors, including baseline intercept. Mixture effects of all growth factors were assessed through quantile-based g-computation. Repeated generalized linear regressions identified significant growth factors. Sex stratification was performed.

RESULTS

The linear-quadratic model was the most optimal trajectory model. No mixture effect was detected. Regression models showed some growth factors saliently linked to the p-factor, internalizing problems, anxiety, hyperactivity, and aggression. The majority of them were baseline intercepts. Quadratic growth factors about mother tongues correlated with anxiety among sex-combined participants and males. The linear growth factor in the proportion of households of couples without children was associated with internalizing problems in females.

LIMITATIONS

We were limited to including only neighborhood-level social exposures, and the multilevel contextual exposome situation interfered with our assessment.

CONCLUSIONS

Trajectories of the social neighborhood exposome modestly influenced late adolescent mental health. Tackling root causes of social inequalities through targeted programs for living conditions could improve adolescent mental health.

Do Municipal Contexts Matter for Adolescent Mental Health? A Within-Municipality Analysis of Nationwide Norwegian Survey Data Across Six Years

Despite growing concerns about substantial socio-economic differences between districts in many developed nations, limited attention has been paid to how adolescent mental health may be shaped by district characteristics. A few studies have shown that adolescent mental health is related to contextual factors such as district socio-economic status, neighborhood disorder, and quality of infrastructure. However, prior estimates may be an artifact of unmeasured differences between districts. To address these concerns, we used data from the nationwide Norwegian Ungdata surveys (N = 278,764), conducted across the years 2014 to 2019. We applied three-level hierarchical linear models to examine within-municipality associations between municipal factors and adolescent mental health in the domains of internalizing problems (i.e., depressive symptoms), externalizing problems (i.e., behavioral problems), and well-being (i.e., self-esteem), thereby accounting for all time-invariant municipality-level confounders. Our results showed that municipal-level safety, infrastructure, and youth culture are associated with adolescent mental health problems. Further, cross-level interaction models indicated gender-specific associations, with stronger associations of municipality infrastructure and community belongingness with increased self-esteem and reduced delinquent behaviors among girls than boys. Our findings highlight that municipality-level interventions may be a feasible strategy for adolescent mental health, even in a society characterized by low inequality and high redistribution.

Examining Multilevel Correlates of Geographic Mobility in a Sample of US Young Adults Before and During the COVID-19 Pandemic

Before the COVID-19 pandemic, geographic mobility, previously viewed as an indicator of economic stability, was declining among young adults. Yet, these trends shifted during the COVID-19 pandemic; young adults were more likely to move during COVID-19 for reasons related to reducing disease transmission and fewer educational and job opportunities. Few studies have documented the individual and neighborhood characteristics of young adults who moved before and during the pandemic. We used data from a cohort of young adults aged 18-34 in six metropolitan areas to examine individual- and neighborhood-level predictors of mobility before and during the COVID-19 pandemic. The sample was majority female, white, and educated with a bachelor's degree or more. Residents in neighborhoods they lived in were mostly White, US-born, employed, and lived above the poverty level. Before the pandemic, identifying as a sexual minority was significantly related to mobility. During the pandemic, being younger, single, and non-Hispanic were significantly related to mobility. Higher neighborhood poverty was significantly related to mobility before and during the COVID-19 pandemic. Future studies that examine young adult populations who moved during the pandemic are needed to determine whether COVID-19 related moves increase economic instability and subsequent health-related outcomes.

Compositional characteristics of neighbourhoods and of schools as correlates of youths' mental health: A cross-sectional study among Swedish adolescents

AIMS

The study aimed to analyse the association between neighbourhood- and school-level socio-demographic factors and self-reported mental health among adolescents.

METHODS

The study population consisted of 3959 adolescents in southern and central Sweden (the KUPOL study), surveyed in the seventh grade (13 years old) and again in the ninth grade (15 years old). Cross-sectional associations were studied between socio-demographic indicators at neighbourhood level (proportion of adults with high education, without employment, of foreign-born residents) and at school level (proportion of students with at least one parent with high education, of students with a foreign background, mean qualification points in ninth grade) and mental health problems. These were assessed through the Strengths and Difficulties Questionnaire (SDQ). We derived odds ratios (OR) and corresponding 95% confidence intervals (CI) of scale scores above the threshold using multilevel logistic regression models.

RESULTS

After adjustment for individual- and family-level socio-demographic factors, there was an indication of higher OR of mental health problems with increasing proportions of foreign-born and residents without employment, especially among girls and in public schools. Stronger associations in the expected direction were found with the internalising subscale. Socio-demographic factors at the school level were not associated with adolescents' mental health, except in private schools, where increasing proportions of students with highly educated parents were significantly associated with SDQ scores under the threshold (OR=0.91; 95% CI 0.85-0.97).

CONCLUSIONS

The results indicate that equal living conditions may represent important cues to improve the mental health of adolescents. Longitudinal studies are needed to determine any causality.

Neighborhood social environment change in late adolescence predicts substance use in emerging adulthood

This study examines associations of changes in perceived and objective (census-based) neighborhood social environment variables during adolescence with alcohol and marijuana outcomes in emerging adulthood using two waves of data (2013-14 and 2019-20) from a cohort in Southern California (n = 1249). Increasing perceived disorganization predicted greater alcohol consequences and socialization with peers using marijuana. Decreasing objective neighborhood SES predicted fewer alcohol consequences and greater socialization with peers drinking alcohol. Unexpectedly, both decreasing and increasing perceived social cohesion predicted fewer alcohol consequences. Increasing perceived social cohesion predicted lower solitary alcohol use. Findings identify potential environmental targets to prevent substance use during the transition to emerging adulthood, but more research is warranted to understand the complex findings for alcohol consequences.

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.

Assessing the perceived changes in neighborhood physical and social environments and how they are associated with Chinese internal migrants' mental health

BACKGROUND

Migrants experience substantial changes in their neighborhood physical and social environments along their migration journeys, but little is known about how perceived changes in their neighborhood environment pre- and post-migration correlate with their mental health. Our aim was to examine the associations between recalled changes in the perceived neighborhood physical and social environments and migrants' mental health in the host city.

METHODS

We used cross-sectional data on 591 migrants in Shenzhen, China. We assessed their risk of mental illness using the General Health Questionnaire (GHQ). Neighborhood perceptions were collected retrospectively pre- and post-migration. We used random forests to analyze possibly non-linear associations between GHQ scores and changes in the neighborhood environment, variable importance, and for exploratory analysis of variable interactions.

RESULTS

Perceived changes in neighborhood aesthetics, safety, and green space were non-linearly associated with migrants' mental health: A decline in these characteristics was associated with poor mental health, while improvements in them were unrelated to mental health benefits. Variable importance showed that change in safety was the most influential neighborhood characteristic, although individual-level characteristics-such as self-reported physical health, personal income, and hukou (i.e., the Chinese household registration system)-appeared to be more important to explain GHQ scores and also strongly interacted with other variables. For physical health, we found different associations between changes in the neighborhood provoked by migration and mental health.

CONCLUSION

Our findings suggest that perceived degradations in the physical environment are related to poorer post-migration mental health. In addition, it seems that perceived changes in the neighborhood environment play a minor role compared to individual-level characteristics, in particular migrants' physical health condition. Replication of our findings in longitudinal settings is needed to exclude reverse causality.

The multidimensional clustering of health and its ecological risk factors

A diverse set of research has examined the ways in which population-level health and its ecological risk factors are embedded within self-reinforcing structures. Syndemic theory, for example, focuses on the co-occurrence of multiple diseases, whereas the spatial diffusion literature highlights the concentration of poor health among communities sharing geographic boundaries. This study combines these related but disciplinarily-isolated perspectives to examine the clustering of population-level health and its determinants across four dimensions: co-occurrence, spatial, temporal, and social network. Using data on U.S. county-level health outcomes and health factors from the Robert Wood Johnson Foundation's County Health Rankings, this study estimates associations between health outcomes within communities and the co-occurrence of community-level factors theorized to influence ecological health. Not only do health outcomes and their ecological risk factors cluster within counties, but also between geographically adjacent counties and counties connected via migration network pathways. Moreover, the self-reinforcing structures uncovered across the co-occurrence, spatial and network dimensions persist over time, and this clustering has consequences on county health and well-being. Rather than adopting the perspective that either health and its community-level factors should be broadly targeted and detached from local context or communities are different, have unique needs and thus should be treated in isolation, the approach advanced in this study identifies shared vulnerabilities in a way that allows for the development of knowledge networks between communities dealing with similar issues.

Neighbourhood deprivation effects on young people's mental health and well-being: A systematic review of the literature

Since the growth of research into neighbourhood effects on young people's health in the 1980s, there have been major societal changes and scientific methodological advancements. In this systematic review we will, therefore, discuss the recent (>2009) literature on the association between neighbourhood deprivation and young people's (0-19 years old) mental health and well-being. We focus on whether neighbourhood deprivation effects exist, and how and for whom the neighbourhood matters. Together, the thirty studies included in the review indicate that overall there are neighbourhood effects on young people's mental health and well-being. The comparison of results from these studies suggests that such associations were more commonly found for well-being and externalising problem behaviour rather than internalising problem behaviour. Also, mental health and well-being seemed to be more often associated with the neighbourhood social environment than neighbourhood socio-economic status and neighbourhood disorder. Studies investigating mediating processes between the linkage between neighbourhood deprivation and mental health and well-being were rare although there was some evidence that processes within the family and peer context are important mechanisms in this linkage. Inconsistent evidence was found regarding the moderating role of age, gender, and ethnicity. There are ongoing challenges of researching the how and for whom neighbourhoods are important. We should work towards rigorous theory and evidence on how different features of residential contexts matter and on differential exposure and vulnerability to these contexts.

Neighborhood Poverty and Physical Health at Midlife: The Role of Life-Course Exposure

Studies of the effect of neighborhood poverty on health are dominated by research designs that measure neighborhood poverty at a single point in time, ignoring the potential influence of exposure to neighborhood poverty over the life course. Applying latent class analysis to restricted residential history data from the National Longitudinal Survey of Youth, 1979 Cohort, we identify four trajectories of life-course exposure to high-poverty neighborhoods between adolescence and midlife and then examine how these groups differ in their physical health conditions (SF-12 score) and self-rated health at around age 40. Linear and logistic regression analyses show that life-course exposure to high-poverty neighborhoods is a stronger predictor of midlife physical health than are point-in-time measures of neighborhood poverty observed during either adolescence or midlife. Our findings suggest that a life-course approach can enhance our understanding of how neighborhood poverty affects physical health.

Changing levels of local crime and mental health: a natural experiment using self-reported and service use data in Scotland

Background

This study contributes robust evidence on the association between mental health and local crime rates by showing how changing exposure to small area-level crime relates to self-reported and administrative data on mental health.

Methods

The study sample comprised 112 251 adults aged 16–60 years, drawn from the Scottish Longitudinal Study, a 5.3% representative sample of Scottish population followed across censuses. Outcomes were individual mental health indicators: self-reported mental illness from the 2011 Census and linked administrative data on antidepressants and antipsychotics prescribed through primary care providers in the National Health Service in 2010/2012. Crime rates at data zone level (500–1000 persons) were matched to the participants’ main place of residence, as defined by general practitioner patient registration duration during 2004/2006, 2007/2009 and 2010/12. Average neighbourhood crime exposure and change in area crime were computed. Covariate-adjusted logistic regressions were conducted, stratified by moving status.

Results

In addition to average crime exposure during follow-up, recent increases in crime (2007/2009–2010/2012) were associated with a higher risk of self-reported mental illness, among ‘stayers’ aged 16–30 years (OR=1.11; 95% CI 1.00 to 1.22), and among ‘movers’ aged 31–45 years (OR=1.07; 95% CI 1.01 to 1.13). Prescribed medications reinforced these findings; worsening crime rates were linked with antidepressant prescriptions among young stayers (OR=1.09; 95% CI 1.04 to 1.14) and with antipsychotic prescriptions among younger middle-aged movers (OR=1.11; 95% CI 1.01 to 1.23).

Conclusion

Changing neighbourhood crime exposure is related to individual mental health, but associations differ by psychiatric conditions, age and moving status. Crime reduction and prevention, especially in communities with rising crime rates, may benefit public mental health.

Neighborhoods and health during the transition to adulthood: A scoping review

Research suggests that neighborhoods play an important role in shaping health outcomes across the life course, but the neighborhood-health link during the transition to adulthood period (18-29 years) is not well studied. A scoping review of 24 studies used thematic analysis to examine the theoretical and methodological approaches of the neighborhood-health literature during this period. Themes illustrate the varied approaches used in this research, including diversity in how neighborhood is defined, theoretical variation regarding the importance of the transition period and the neighborhood-health link, and the importance of gender and race/ethnicity to this area of study. While the literature on this topic is fragmented, with varied definitions and minimal theoretical coherence, all studies found some degree of support for the relationship between neighborhoods and health during the transition to adulthood. Our analysis suggests that future research should focus on developing a theoretical foundation for these relationships in order to clarify key concepts and advance a science to better understand how and why neighborhoods affect health during this period.

Trajectories of Depressive Symptoms and Neighborhood Changes from Adolescence to Adulthood: Latent Class Growth Analysis and Multilevel Growth Curve Models

The role of neighborhood socioeconomic status (SES) and racial/ethnic composition on depression has received considerable attention in the United States. This study examines associations between trajectory patterns of neighborhood changes and depressive symptoms using data from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health. We used latent class growth analysis to determine the number and distribution of person-centered trajectories for neighborhood characteristics, and multilevel growth curve models to examine how belonging to each class impacted depression trajectories from ages 13 to 32 among non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), Hispanics, and non-Hispanic Others (NHO). The distribution of neighborhood SES classes across racial/ethnic groups suggests significant levels of economic inequality, but had no effect on depressive symptoms. A more complex picture emerged on the number and distribution of racial/ethnic composition latent class trajectories. Compared to NHB peers who lived in predominantly NHW neighborhoods from adolescence to adulthood, NHBs in more diverse neighborhoods had lower risk for depressive symptoms. Conversely, Hispanics living in neighborhoods with fewer NHWs had higher risk for depressive symptoms. Among NHOs, living in neighborhoods with a critical mass of other NHOs had a protective effect against depressive symptoms.

Why Public Health Needs GIS: A Methodological Overview

The short paper provides an overview on how geographic issues have become increasingly relevant to public health research and policy, particularly through the lens of geographic information systems (GIS). It covers six themes with an emphasis on methodological issues. (1) Our health-related behavior varies across geographic settings, so should public health policy. (2) Facilities (supply) and patients (demand) in a health care market interact with each other across geopolitical borders, and measures of health care accessibility need to capture that. (3) Our health outcome is the result of joint effects of individual attributes and neighborhood characteristics, and an adequate definition of neighborhood is critical for assessing neighborhood effect. (4) Disease rates in areas of small population are unreliable, and one effective way to mitigate the problem is to construct a larger, internally-homogenous and comparable area unit. (5) Defining a scientific geographic unit for health care market is critical for researchers, practitioners, and policy makers to evaluate health care delivery, and GIS enables us to define the unit (e.g., primary care service areas, hospital service areas, and cancer service areas) automatically, efficiently and optimally. (6) Aside from various optimization objectives around "efficiency", it is as important to plan the location and allocation of health care resources toward maximum equality in health care access. Case studies are cited to illustrate each theme.

Neighborhoods, psychological distress, and the quest for causality

Neighborhood characteristics have been associated with psychological distress, but it is uncertain whether these associations are causal. The current article reviews data from interventions and quasi-experimental studies that have addressed the question of causality of neighborhood associations. Overall, data from neighborhood interventions, longitudinal studies, and twin studies have provided only limited and inconsistent evidence to support causal interpretation of neighborhood associations with psychological distress: very few findings have been replicated across different samples, and many associations have been observed only with some of the multiple measures included the studies. Studies that examine the effects of neighborhood change on people's wellbeing are needed to improve causal inference and policy relevance of neighborhood studies.

Contextual Socioeconomic Disadvantage and Adolescent Suicide Attempts: A Multilevel Investigation

Multilevel research on whether and how contextual socioeconomic disadvantage affects adolescent suicidal behaviors is scarce. Using data from the first two waves (1994/95 and 1996) of the National Longitudinal Study of Adolescent to Adult Health (N = 13,335; 49.63% girls; M_age = 15.02 years), this study examined (1) the association between area-level socioeconomic disadvantage and adolescent suicide attempts over and above individual-level socioeconomic factors, (2) the moderating role of gender, and (3) the mediating roles of contextually relevant stressors and available psychosocial resources. The results revealed that area-level socioeconomic disadvantage increased the risk of attempting suicide even after adjusting for individual-level socioeconomic status, especially for boys. Consistent with the stress process perspective, reports of exposure to violence and lack of safety explain this contextual effect. National suicidal behavior prevention strategies across the U.S. should recognize the strong association with the socioeconomic context, along with individual-level risk factors.

Toward dynamic urban environmental exposure assessments in mental health research

It is increasingly recognized that mental disorders are affected by both personal characteristics and environmental exposures. The built, natural, and social environments can either contribute to or buffer against metal disorders. Environmental exposure assessments related to mental health typically rely on neighborhoods within which people currently live. In this article, I call into question such neighborhood-based exposure assessments at one point in time, because human life unfolds over space and across time. To circumvent inappropriate exposure assessments and to better grasp the etiologies of mental disease, I argue that people are exposed to multiple health-supporting and harmful exposures not only during their daily lives, but also over the course of their lives. This article aims to lay a theoretical foundation elucidating the impact of dynamic environmental exposures on mental health outcomes. I examine, first, the possibilities and challenges for mental health research to integrate people's environmental exposures along their daily paths and, second, how exposures over people's residential history might affect mental health later in life. To push the borders of scientific inquiries, I stress that only such mobility-based approaches facilitate an exploration of exposure duration, exposure sequences, and exposure accumulation.