Gender differences in the social pathways linking neighborhood disadvantage to depressive symptoms in adults

Examining the relationship between biomarkers of immune aging and prevalent physical disability in the health and retirement study

INTRODUCTION

Large social inequities have been repeatedly observed in physical disability. While inflammation has been identified as a potential underlying biological mechanism to proxy immune processes, the general inflammatory measures available in many population health studies lack specificity in capturing the complex nature of immune function. Therefore, we sought to examine whether specific biomarkers of immune function are associated with the prevalence of physical disability.

METHODS

We leveraged data from 8,543 adults (mean age = 69 years, 54 % women) in the nationally-representative Health and Retirement Study and employed gender-stratified Poisson regression models to examine whether a more aged immune profile, indicated by higher values in each marker of immune aging (CD8+:CD4+, EMRA CD4+:Naïve CD4+, EMRA CD8+:Naïve CD8+, and CMV IgG), was associated with a higher prevalence of activities of daily living (ADL) disability.

RESULTS

After adjustment, among women, one standard deviation (SD) increase in CMV IgG was associated with 12 % higher prevalence of ADL disability (PR: 1.12; 95 % CI: 1.04, 1.21). Similarly each 1-SD increase in the CD8 + CD4 + ratio was associated with a 9 % higher prevalence of ADL disability (PR: 1.09; 95 % CI: 1.03, 1.16). No associations were observed among men across any of the immune measures.

DISCUSSION

Our findings provide initial support that biomarkers of immune aging may serve as an important mechanism in understanding physical disability, particularly among women.

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.

Effect of Age-Friendly Communities Action Plan on Trajectories of Older Canadians' Depressive Symptoms Between 2018 and 2020: Multilevel Results From the Canadian Longitudinal Study on Aging

As the COVID-19 pandemic impacted mental health, this longitudinal study examined the effect of age-friendly communities (AFC) action plan on older adults' depressive symptoms. Using the CLSA, the CLSA COVID-19 Questionnaire study, survey of Canadian municipalities, and the census, the depressive symptoms trajectories were modeled with multilevel multinomial regressions. Most respondents (66.1%) had non-depressed trajectories, 28.1% experienced a moderate increase in depressive symptoms, and 5.8% had a depressed trajectory. AFC action plans did not have a protective effect on these trajectories. Being a female, greater loneliness, lower income, ≥2 chronic conditions, inferior social participation, weaker sense of belonging, COVID-19 infection, and pandemic stressors predicted a depressed trajectory. Neighborhood's deprivation had a weak protective effect on the declining trajectory. Although AFC action plans provided no benefits during the pandemic, volunteers facilitating resource access and social interactions could limit any increase in depressive symptoms.

Age and sex differences in the association between neighborhood socioeconomic environment and incident diabetes: Results from the diabetes location, environmental attributes and disparities (LEAD) network

Objective

Worse neighborhood socioeconomic environment (NSEE) may contribute to an increased risk of type 2 diabetes (T2D). We examined whether the relationship between NSEE and T2D differs by sex and age in three study populations.

Research design and methods

We conducted a harmonized analysis using data from three independent longitudinal study samples in the US: 1) the Veteran Administration Diabetes Risk (VADR) cohort, 2) the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, and 3) a case-control study of Geisinger electronic health records in Pennsylvania. We measured NSEE with a z-score sum of six census tract indicators within strata of community type (higher density urban, lower density urban, suburban/small town, and rural). Community type-stratified models evaluated the likelihood of new diagnoses of T2D in each study sample using restricted cubic splines and quartiles of NSEE.

Results

Across study samples, worse NSEE was associated with higher risk of T2D. We observed significant effect modification by sex and age, though evidence of effect modification varied by site and community type. Largely, stronger associations between worse NSEE and diabetes risk were found among women relative to men and among those less than age 45 in the VADR cohort. Similar modification by age group results were observed in the Geisinger sample in small town/suburban communities only and similar modification by sex was observed in REGARDS in lower density urban communities.

Conclusions

The impact of NSEE on T2D risk may differ for males and females and by age group within different community types.

Changes in neighborhood physical and social environments matter for change in mental health: Longitudinal evidence from Dutch panel data

Numerous neighborhood environments have been recognized to affect mental health, but only a few longitudinal studies investigated these associations jointly and whether different population groups are affected differently. We used three-wave panel data of 2699 adults between 2010 and 2016 in the Netherlands to assess the associations between changes in neighborhood physical and social environments and mental health changes. Further, we assessed possible effect modification of gender and income. Mental health was measured using the Mental Health Inventory. Time-varying exposure to green space, blue space, population density, air pollution, socioeconomic deprivation, and social fragmentation were assigned based on individuals' neighborhood histories. Fixed-effect regressions were conducted to assess within-person associations between single and multiple exposures on mental health for the entire sample and stratified by gender and income. Our single-exposure models showed that increases in blue space were significantly associated with mental health improvements, while increases in fine particulate matter (PM2.5) resulted in declines in mental health. These associations were not attenuated in the multi-exposure model. We observed no significant associations for the remaining environments. Stratification analyses showed that females' mental health further declined as PM2.5 concentrations increased compared to males. Increasing levels of socioeconomic deprivation were associated with further declines in mental health among the less well-off compared with higher-income earners. Our longitudinal findings suggested that neighborhood physical and social environment changes were associated with mental health changes. Future research is required to establish the underlying pathways.

Social determinants of health and gender differences in depression among adults: A cohort study

The role of social determinants of health (SDoH) in gender differences in depression remains unclear among Chinese adults. We aimed to explore the association between SDoH and depression and investigate their role in explaining gender differences in depression. This prospective longitudinal cohort study used four wave surveys (2012, 2016, 2018, and 2020) of the China Family Panel Study (CFPS). Fourteen SDoH variables were assessed, and depression was measured using the 8-item short version of the Center for Epidemiologic Studies Depression Scale. The Cox proportional hazards regression and multiple mediation analysis were performed to estimate the effect sizes. The longitudinal sample included 18,874 participants aged 18-92 years (51.4 % males and 48.6 % females). Women had higher risk of depression than men. Unfavorable SDoH were associated with higher risk of depression. After including multiple SDoH in mediation analysis, multiple SDoH mediated 15.7 % of the total effect of gender on depression. In sum, SDoH significantly influenced depression, and specific factors explained gender differences in depression. Supporting women in education, employment, and community involvement could help reduce gender differences in depression.

Gentrification, perceptions of neighborhood change, and mental health in Montréal, Québec

While census-defined measures of gentrification are often used in research on gentrification and health, surveys can be used to better understand how residents perceive neighborhood change, and the implications for mental health. Whether or not gentrification affects mental health may depend on the extent to which an individual perceives changes in their neighborhood. Using health and map-based survey data, collected from 2020 to 2021, from the Interventions, Research, and Action in Cities Team, we examined links between perceptions of neighborhood change, census-defined neighborhood gentrification at participant residential addresses, and mental health among 505 adults living in Montréal. After adjusting for age, gender, race, education, and duration at current residence, greater perceived affordability and more positive feelings about neighborhood changes were associated with better mental health, as measured by the mental health component of the short-form health survey. Residents who perceived more change to the social environment had lower mental health scores, after adjusting individual covariates. Census-defined gentrification was not significantly associated with mental health, and perceptions of neighborhood change did not significantly modify the effect of gentrification on mental health. Utilizing survey tools can help researchers understand the role that perceptions of neighborhood change play in the understanding how neighborhood change impacts mental health.

The role of area-level socioeconomic disadvantage in racial disparities in cancer incidence in metropolitan Detroit

BACKGROUND

Neighborhood deprivation is associated with both race and cancer incidence, but there is a need to better understand the effect of structural inequities on racial cancer disparities. The goal of this analysis was to evaluate the relationship between a comprehensive measure of neighborhood-level social disadvantage and cancer incidence within the racially diverse population of metropolitan Detroit.

METHODS

We estimated breast, colorectal, lung, and prostate cancer incidence rates using Metropolitan Detroit Cancer Surveillance System and US decennial census data. Neighborhood socioeconomic disadvantage was measured by the Area Deprivation Index (ADI) using Census Bureau's American Community Survey data at the Public Use Microdata Areas (PUMA) level. Associations between ADI at time of diagnosis and cancer incidence were estimated using Poisson mixed-effects models adjusting for age and sex. Attenuation of race-incidence associations by ADI was quantified using the "mediation" package in R.

RESULTS

ADI was inversely associated with incidence of breast cancer for both non-Hispanic White (NHW) and non-Hispanic Black (NHB) women (NHW: per-quartile RR = 0.92, 95% CI 0.88-0.96; NHB: per-quartile RR = 0.94, 95% CI 0.91-0.98) and with prostate cancer incidence only for NHW men (per-quartile RR = 0.94, 95% CI 0.90-0.97). ADI was positively associated with incidence of lung cancer for NHWs and NHBs (NHW: per-quartile RR = 1.12, 95% CI 1.04-1.21; NHB: per-quartile RR = 1.37, 95% CI 1.25-1.51) and incidence of colorectal cancer (CRC) only among NHBs (per-quartile RR = 1.11, 95% CI 1.02-1.21). ADI significantly attenuated the relationship between race and hormone receptor positive, HER2-negative breast cancer (proportion attenuated = 8.5%, 95% CI 4.1-16.6%) and CRC cancer (proportion attenuated = 7.3%, 95% CI 3.7 to 12.8%), and there was a significant interaction between race and ADI for lung (interaction RR = 1.22, p < 0.0001) and prostate cancer (interaction RR = 1.09, p = 0.00092).

CONCLUSIONS

Area-level socioeconomic disadvantage is associated with risk of common cancers in a racially diverse population and plays a role in racial differences in cancer incidence.

Gender Disparities Between Neighborhood Social Vulnerability and Psychological Distress Among Patients with Heart Disease

Background: Psychological stress disorders are twice as prevalent in women with ischemic heart disease compared to men. The disproportionate psychological health experience of these women is not well understood. The objective of this study was to examine whether neighborhood social factors are associated with disparities in psychological health by gender. Materials and Methods: We studied 286 patients with heart disease recruited from Emory-based hospitals in the Myocardial Infarction and Mental Stress 2 Study (n = 286). A global measure of psychological distress was calculated by taking an average of ranks across symptom scales for depression, post-traumatic stress disorder, anxiety, anger, and perceived stress. The social vulnerability index (SVI) was developed by the Centers for Disease Control and Prevention and was used to rank patients' census tracks on 14 social factors. Beta coefficients for mean ranks in psychological distress scores were estimated per 10-unit increase in SVI percentile ranking using multilevel regression models. Results: The mean age of the sample was 51 years, 49% were women, and 66% African American. After adjusting for demographics, cardiovascular risk factors, and antidepressant use, each 10-unit increase in SVI percentile ranking was associated with 4.65 (95% CI: 0.61-8.69; p = 0.02) unit increase in mean scores for psychological distress among women only (SVI-by-gender-interaction = 0.01). These associations were driven by the SVI themes of lower socioeconomic status and poorer access to housing and transportation. Conclusion: Neighborhood social vulnerability may be a psychosocial stressor that potentiates women's susceptibility to adverse psychological and cardiovascular health.

Opening the black box of the relationship between neighborhood socioeconomic status and mental health: Neighborhood social-interactive characteristics as contextual mechanisms

Previous studies have linked low neighborhood socioeconomic status (NSES) to mental health problems. However, few studies have investigated the mechanisms underlying this association and most focused on the association with negative indicators of mental health, such as symptoms of depression or anxiety. This paper investigated whether neighborhood social characteristics (social interaction, trust, safety, organization participation, and attachment) mediate the association between NSES and mental health. We combined Danish register data with survey data from the North Denmark Region Health Survey 2017. Mental health was assessed with the Rand 12-item Short-form Survey (SF-12). The sample consisted of 14,969 individuals nested in 1047 neighborhoods created with an automated redistricting algorithm. We fitted multilevel structural equation mediation models and used a Monte Carlo simulation method to estimate confidence intervals for the indirect effects. NSES was positively associated with mental health. Neighborhood trust significantly mediated this relationship, accounting for 34% of the association after controlling for other mediators. These results indicate that higher levels of mental health in more affluent neighborhoods are partially explained by higher levels of trust. Improving neighborhood trust could mitigate sociogeographic inequalities in mental health.

Trauma and Trust: How War Exposure Shapes Social and Institutional Trust Among Refugees

The brutal wars in Iraq, Syria and now Ukraine have caused a massive influx of refugees to Europe. Turkey alone has received more than 4.8 million refugees. An important precondition for their economic and social incorporation is trust: refugees need to trust the citizens as well as the state and the justice system to find their place in the host country. Yet refugees’ propensity to trust may be affected by cultural differences between their home and host countries, their personal conflict exposure and the experiences they had on the run. This study investigates how individual differences in exposure to armed conflict and institutional breakdown shape two types of trust among refugees: Generalized social trust and trust in the institutions of the settlement country. We survey a large and diverse sample of refugees from Syria and Iraq living in Turkish communities and deploy well-established measures of conflict exposure, posttraumatic stress, and posttraumatic growth. We find that higher degrees of conflict exposure are positively related to social trust, and to trust in courts and the police. These positive findings are largely driven by refugees who had very personal and emotionally powerful experiences. The psychological mechanism of posttraumatic growth cannot explain these findings, however, suggesting positive experiences of cooperation in the midst of war and displacement are potentially a better explanation for this finding than positive psychological changes resulting from trauma. At the same time, conflict exposure is negatively related to trust in political institutions. Posttraumatic stress may be the mechanism behind this result. We discuss the implications of these findings for the integration of war refugees—a topic that is tragically of great relevance today.

Neighborhood Disadvantage and Poor Health: The Consequences of Race, Gender, and Age among Young Adults

The objective of this study is to examine the relationship between neighborhood disadvantage and poor self-rated health for a nationally representative sample of Blacks and Whites in young adulthood, 18 to 30 years old. Data were from 16 waves (1997–2013) of the National Longitudinal Survey of Youth 1997 cohort (N = 6820 individuals; observations = 58,901). Utilizing the stress process model and generalized estimating equations to account for the correlated nature of multiple responses over time, results show that neighborhood disadvantage increases the odds of poor health for all groups. This positive association is strongest in the most disadvantaged neighborhoods and is heightened as young adults age. There are also notable race and gender differences. For example, Blacks, who live in the most highly disadvantaged neighborhoods, seem to be somewhat shielded from the most deleterious effects of poor neighborhood conditions compared to their White counterparts. Despite greater proportions of Blacks residing in harsh neighborhood environments, Black men experience better health than all other groups, and the health of Black women is no worse compared to White men or women. Limitations and directions for future research are discussed.

Associations of PM2.5 and road traffic noise with mental health: Evidence from UK Biobank

BACKGROUND

The associations of atmospheric particulate matter with diameters of 2.5 μm or less (PM2.5) and road traffic noise with mental disorders in men and women are not well studied.

OBJECTIVES

We aim to examine the cross-sectional associations of PM2.5 and road traffic noise with mental disorders in men and women.

METHODS

The baseline data of the UK Biobank study (2006-2010) were used. Mental disorders including symptoms of nerves, anxiety, tension or depression (NATD), major depression, and bipolar disorder were assessed by validated questions. Verified models were used to estimate PM2.5 and road traffic noise.

RESULTS

A total of 334,986 participants with measurements of NATD and 90,706 participants with measurements of major depression and bipolar disorder were included in the analysis. After adjusting for covariates, the odds for the risk of NATD symptoms increased by 2.31 (95% CI: 2.15-2.50) times per 10 μg/m³ increase in PM2.5. The odds for the risk of major depression and bipolar disorder increased by 2.26 and 4.99 times per 10 μg/m³ increase in PM2.5. On the other hand, higher road traffic noise exposure was significantly associated with a higher risk of NATD symptoms (Decile 6-8 (54.9-57.8 dB), OR: 1.03, 95% CI: 1.01-1.06; Decile 9-10 (≥57.8 dB), OR: 1.04, 95% CI: 1.01-1.07) and bipolar disorder (Decile 2-5 (52.1-54.9 dB), OR: 1.26, 95% CI: 1.00-1.59; Decile 6-8 (54.9-57.8 dB), OR: 1.30, 95% CI: 1.02-1.65; Decile 9-10 (≥57.8 dB), OR: 1.54, 95% CI: 1.21-1.97). Interestingly, a negative association was observed between moderate road traffic noise and major depression (Decile 2-5 (52.1-54.9 dB), OR: 0.95, 95% CI: 0.90-1.00). Interactions between PM2.5 exposure with age, gender, and sleeplessness for NATD symptoms were observed (P < 0.05), while interactions between road traffic noise exposure with age and gender were observed (P < 0.05).

CONCLUSIONS

We found a positive association between PM2.5 and mental disorders. Meanwhile, we found a positive association of road traffic noise with NATD symptoms and bipolar disorder and a negative association of moderate road traffic noise with major depression. Also, the effect modifications of these associations by age, gender, or sleeplessness may exist.

Does the longitudinal association between neighbourhood cohesion and mental health differ by ethnicity? Results from the UK Household Longitudinal Survey

PURPOSE

While the association between neighbourhood cohesion and mental health has been widely studied in the general population, the effects of neighbourhood cohesion across ethnic groups are not well understood. Ethnicity is often left out of study design, many studies do not consider effect modification by ethnicity, or they rely on overly simplistic ethnic categories.

METHODS

Data from the UK household longitudinal study were used to investigate whether changes in neighbourhood cohesion are independently associated with changes in mental health (measured using the GHQ) over 9 years (2009-2018), and whether the association differed across 17 ethnic groups. The study used a fixed-effect modeling approach that includes within-person estimators that allow each participant to act as their own control.

RESULTS

Compared to British White, the following ethnic groups all saw a similar improvement in GHQ (- 0.76, 95% CI - 0.83 to - 0.70) for each point increase in neighbourhood cohesion: Irish, any other White, White and Asian mixed, Chinese, Caribbean, African, any other Black, Arab, and others. Some ethnic groups saw stronger improvements in mental for each point increase in neighbourhood cohesion, including White and Black Caribbean mixed, any other mixed, Indian, Pakistani, any other Asian, with the strongest effect seen in Bangladeshi participants (- 2.52. 95% CI - 3.48 to - 1.56).

CONCLUSION

Our study highlights the importance of ethnocultural data in research examining neighbourhood effects on mental health. Future research should evaluate policies to improve neighbourhood cohesion for ethnic minorities to address ethnic mental health disparities.

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.

Neighborhood Socioeconomic Deprivation and Depression Symptoms in Adults From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Socioeconomic factors appear to impact mental health conditions such as depression, but little is known about the relative and combined role of neighborhood and personal socioeconomic deprivation among Hispanics/Latinos. This study examined cross-sectional associations of neighborhood and personal socioeconomic deprivation with depression symptoms in a US Hispanic/Latino population from the San Diego Field Center of the Hispanic Community Health Study/Study of Latinos (n = 3,851). Depression symptoms were assessed with the ten-item Centers for Epidemiological Studies in Depression Scale. Neighborhood socioeconomic deprivation was a composite of eleven variables (e.g., neighborhood income, education, employment, household crowding). Greater personal socioeconomic deprivation based on education, income, and employment was generally associated with higher depression symptoms, including after adjusting for neighborhood socioeconomic deprivation. Greater neighborhood socioeconomic deprivation was associated with higher depression symptoms in females but not males, but the association in females became non-significant when adjusting for personal socioeconomic deprivation. Neighborhood socioeconomic deprivation did not significantly interact with personal socioeconomic deprivation in relation to depression symptoms. The present findings support the association of personal socioeconomic status with mental health (indicated by depression symptoms) among Hispanic/Latino populations, whereas neighborhood socioeconomic deprivation did not relate to depression beyond the impact of personal indicators.

Impact of social capital, sex and education on the utilization of public health services: a cross sectional study based on the China migrant dynamic survey

Background

China is making efforts to promote the equalization of National Essential Public Health Services (NEPHS) for internal migrants. Studies have demonstrated that the impacts of social capital on health services are different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of NEPHS for the internal migrants and provide reference for other countries.

Methods

Data from the China Migrant Dynamic Survey of 2017, involving 130,642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of NEPHS. Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such impacts are moderated by sex and education.

Results

(1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different sexs and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by sex. However, a high education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education.

Conclusion

Social capital plays an important role in the access of migrants to NEPHS. Governments should vigorously promote the construction of regional social capital, encourage migrants to actively participate in community activities, especially pay attention to the enhancement of the migrants with low SES to the destination identity.

The effect of neighbourhood cohesion on mental health across sexual orientations: A longitudinal study

Given the persistent mental health disparities between sexual minorities and the general population, social epidemiological research should address this disparity by investigating the differential impact of neighbourhood social environments across sexual orientations. There is growing evidence that neighbourhood cohesion, conceptualized as a sense of belonging and social connection, is an important social determinant of mental health in the general population, but little is known about its impact across sexual orientations. Using data from the UK household longitudinal study (2009-2018) including waves 1, 3, 6, and 9 ( n = 52,903), this paper examined the longitudinal relationship between neighbourhood cohesion and mental health (using GHQ-12) across sexual orientations. A fixed-effect regression approach was taken to model the within-person change over time in GHQ predicted by neighbourhood cohesion with disaggregated analyses by gender and sexual orientation. Across all sexual orientations and genders, individuals who experienced an increase in neighbourhood cohesion also saw an improvement in their mental health over time. Moreover, the effect of neighbourhood cohesion on mental health over time differed by sexual orientation. Each 1-point increase in neighbourhood cohesion (on a 5-point scale) lead to mental health improvements of -0.8 GHQ score (95%CI -0.89 to -0.71) for heterosexual males at the lowest end, and up to -1.71 GHQ score (95%CI -2.31 to - 1.11) for homosexual men at the highest end. Given that the study demonstrates notable differences in the effects of neighbourhood social environment across gender and sexual orientations, this points to the need to consider sexual orientation (along with gender) as a key modifier in research involving neighbourhood effects. Future studies should evaluate the effectiveness of specific policies aimed at improving neighbourhood social environment for sexual minorities to help close mental health disparities.

Area deprivation, perceived neighbourhood cohesion and mental health at older ages: A cross lagged analysis of UK longitudinal data

Previous research on neighbourhood influences on older adults' mental health shows inconsistent evidence for effects of neighbourhood deprivation but stronger evidence for effects of perceived neighbourhood social cohesion, often proposed as a mediator of the link between neighbourhood deprivation and mental well-being. However, it is possible that mental health influences perceptions of neighbourhoods; this has rarely been considered. We use data from a large UK longitudinal study to investigate these associations. Results from cross-lagged models indicate that greater neighbourhood deprivation is associated with worse perceived social cohesion and worse mental health. Associations between change in perceived social cohesion and in mental health were reciprocal-lower perceived cohesion predicted poorer mental health and vice versa. Further research including three waves of data is needed to further unravel underlying directions of association.

Childhood neighborhood quality, friendship, and risk of depressive symptoms in adults: The China health and retirement longitudinal study

BACKGROUND

Understanding the contribution of childhood neighborhood quality (CNQ) and childhood friendship (CF) to the development of depressive symptoms during adulthood among the general population is of great importance to public health. This study aims to examine the longitudinal associations of CNQ and CF with the risk of later-life depressive symptoms in a representative Chinese population.

METHODS

The data were from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptom score was measured by the 10-item Center for Epidemiological Studies-Depression Scale (CES-D10). CNQ and CF were measured by a standardized questionnaire.

RESULTS

A total of 13,354 individuals were included in our study. The participants with higher CNQ had a significantly low risk of depressive symptoms than those with lower CNQ score (OR=0.93, 95%CI: 0.92-0.93, P<0.001), and the association remained significant (OR=0.93, 95%CI: 0.91-0.95, P<0.001) after further adjustment for covariates. The participants with a higher CF score had a significantly low risk of depresssive symptoms than those with a lower CF score (adjusted OR=0.97, 95%CI: 0.96-0.98, P<0.001). Moreover, the associations of CNQ and CF score with the risk of depressive symptoms were significantly modulated by education level (both P<0.001), which means that high education level enlarged the inverse associations of CNQ/CF with depressive symptoms.

CONCLUSIONS

Higher CHQ and CF score are significantly associated with the lower risk of depressive symptoms in adulthood. Education attainment may mediate the associations of CNQ and CF with the risk of depressive symptoms.

The impact of financial hardship in childhood on depression and anxiety in adult life: Testing the accumulation, critical period and social mobility hypotheses

This paper examines the association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood with reference to the accumulation, critical period and social mobility hypotheses in lifecourse epidemiology. Using the BBC Stress test, linear regression models were used to investigate the associations for the whole population and stratifying by gender and adjusting for age and highest education attainment. The critical period hypothesis was not confirmed. The accumulation hypothesis was confirmed and stratifying by gender women had a higher estimated mean GAD score if they were poor in both childhood and adulthood compared to men. Our findings do not support the social mobility hypothesis. However, stratifying by gender, a clear difference emerged with upward mobility having a favourable impact (lower) on women's mean GAD scores, while upward social mobility in adulthood did not attenuate the impact of financial hardship in childhood or men. The impact of financial hardship in childhood on later mental health outcomes is particularly concerning for future health outcomes as current levels of child poverty increases in the UK.

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The association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood was tested.

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A lifecourse approach was used.

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Two episodes of financial hardship had a greater impact on women’s Goldberg Anxiety & Depression score compared to men.

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Upward mobility had a favourable impact on women's mean Goldberg Anxiety & Depression scores, but not for men.

The impact of childhood socioeconomic status on depression and anxiety in adult life: Testing the accumulation, critical period and social mobility hypotheses

This paper examines the association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood with reference to the accumulation, critical period and social mobility hypotheses in lifecourse epidemiology. Using the BBC Stress test, linear regression models were used to investigate the associations for the whole population and stratifying by sex and adjusting for age and highest education attainment. The critical period hypothesis was not confirmed. The accumulation hypothesis was confirmed and stratifying by sex women had a higher estimated mean GAD score if they were poor in both childhood and adulthood compared to men. Our findings do not support the social mobility hypothesis. However, stratifying by sex, a clear difference emerged with upward mobility having a favourable impact (lower) on women's mean GAD scores, while upward social mobility in adulthood did not attenuate the impact of financial hardship in childhood or men. The impact of financial hardship in childhood on later mental health outcomes is particularly concerning for future health outcomes as current levels of child poverty increases in the UK.

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The association between socioeconomic status in childhood and adulthood, and depression and anxiety in adulthood was tested.

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A lifecourse approach was used.

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Two episodes of financial hardship had a greater impact on women’s Goldberg Anxiety & Depression score compared to men.

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Upward mobility had a favourable impact on women's mean Goldberg Anxiety & Depression scores, but not for men.

Accumulated Disadvantage over the Lower Secondary School Years in Helsinki Metropolitan Area, Finland

Accumulated disadvantage (AD) is conceptualised here as an agglomeration of unfavourable or prejudicial conditions which in adolescence may compromise the progress to further education or future life chances. There are several theories on AD, suggesting, e.g., (1) an increase of AD by age and (2) trajectories (previous disadvantage predicts later disadvantage). Social pathways theory suggests that (3) a third factor (e.g., socioeconomic position, SEP) mediates or moderates the association between early and later disadvantage, while other theories imply (4) polarisation (a strengthening association between AD and SEP by age) or (5) equalisation (a weakening of association between AD and SEP). We apply these theories to longitudinal data of 7th graders (13 years, N = 5742), followed until the end of the 9th grade. Five dimensions of disadvantage were health (poor self-rated health), social behaviour (poor prosocial behaviour), normative (conduct disorders), educational (poor academic achievement), and economic (parental unemployment). The results show that the prevalence of AD increased over the follow-up as most indicators of disadvantage elevated. AD at the 7th grade predicted later AD, as did the SEP of the students. Moderation of AD by SEP was also observed. The study corroborates with hypotheses on increase of AD, trajectory, and social pathways but no signs of polarisation or equalisation were observed.

Neighborhood features and depression in Mexican older adults: A longitudinal analysis based on the study on global AGEing and adult health (SAGE), waves 1 and 2 (2009-2014)

A growing body of literature shows that neighborhood characteristics influence older adults' mental health. Therefore, the aim of this study was to examine the association between structural and social characteristics of the neighborhood, and depression in Mexican older adults. A longitudinal study was conducted based on waves 1 (2009-2010) and 2 (2014) of the Mexican sample from the Study on global AGEing and adult health (SAGE). A street-network buffer around each participant's household was used to define neighborhood, so that built environment and social characteristics were assessed within it. Depression was ascertained by using an algorithm based on the Composite International Diagnostic Interview. In the analysis, multilevel logistic regression models were constructed separately for each built and social environments measurement, adjusted for socioeconomic, demographic and health-related covariates, and stratified by area of residence (urban versus rural). The results showed that a length of space between 15-45 meters restricted to vehicles was significantly associated with a lower risk of depression in older adults from the urban area (OR: 0.44; IC 95% 0.23-0.83) and the protective association appeared to be larger with increasing space with this restriction, although it lacked significance. Contrarily, the built environment measures were not predictive of depression in the rural setting. On the other hand, none of the variables from the social environment had a significant association, although safety appeared to behave as a risk factor in the overall (OR: 1.48; CI 95% 0.96-2.30; p = 0.08) and rural (OR: 3.44; CI 95% 0.95-12.45; p = 0.06) samples, as it reached marginal significance. Research about neighborhood effects on older adults' mental health is an emergent field that has shown that depression might be treated not only from the individual-level, but also from the neighborhood-level. Additionally, further research is needed, especially in low- and middle-income countries, to help guide neighborhood policies.

Measures of personal social capital over time: A path analysis assessing longitudinal associations among cognitive, structural, and network elements of social capital in women and men separately

Studies on personal social capital and health have relied on several key measures of social capital - trust, participation, network capital - all with the aim of capturing the resources to which individuals or groups might have access through their social networks. As this work has evolved, researchers have sought to differentiate among key measures, often arguing that each represents a different type of social capital. Despite the importance of this work, few studies have examined (a) whether these measures are in fact distinct constructs, particularly over time, (b) if these relationships are causal, and (c) whether gender patterns the ways these measures are related. Using a probability-based sample of adults with 1-3 observations per respondent, we apply generalized structural equation modeling to assess in women and men separately whether generalized trust, trust in neighbors, network diversity, social isolation, and social participation are associated with each other, hypertension, and self-reported health over a five-year period. The initial response rate was 38.7%, with cooperation rates of 60.4% and 56.3% at waves two and three. Findings highlight stability in the longitudinal relationship of the same measure across waves. They also suggest that social capital measures operate differently for men and women, with key measures of one type of social capital more often associated with another type in women than men. Nevertheless, the strengths of the associations remain weak in women and men, particularly over time, suggesting that these measures (especially generalized trust) may be inadequate proxies for each other. Lastly, social capital seemed more salient for women's than men's health. Future research on social capital might consider more deeply the role and meaning of gender in interpreting the results of studies linking social capital to health. Further consideration of trust, participation, and network capital as distinct constructs is also warranted.

Perceived neighborhood social cohesion moderates the relationship between neighborhood structural disadvantage and adolescent depressive symptoms

There is a dearth of research exploring the moderating role of the social environment on neighborhood structural disadvantage and depressive symptoms, particularly among adolescents. Therefore, we examined if adolescent perceptions of neighborhood social cohesion and safety moderated the association between neighborhood structural disadvantage and adolescent depressive symptoms. This cross-sectional study used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). The study sample consisted of 12,105 adolescents enrolled in 9th-12th grades during the 1994-1995 school year across the United States (U.S.). Mixed effects multilevel modeling was used to determine if adolescent perceptions of neighborhoods moderated the relationship between neighborhood structural disadvantage and adolescent depressive symptoms. Results showed that perceived neighborhood social cohesion moderated the relationship between neighborhood structural disadvantage and adolescent depressive symptoms (p ≤ 0.001). At higher levels of perceived neighborhood social cohesion, neighborhood structural disadvantage was associated with decreased depressive symptoms. Findings suggest that improving perceived neighborhood social cohesion may decrease adolescent depressive symptoms, particularly in neighborhoods with high disadvantage. This aspect of the neighborhood social environment may serve as a target for structural and other interventions to address the growing burden of depression among adolescents.

Ten-year change in neighborhood socioeconomic status and colorectal cancer

BACKGROUND

A growing body of research has demonstrated that individuals who live in neighborhoods with more severe socioeconomic deprivation may have higher risks for colorectal cancer (CRC). However, previous studies have examined neighborhood socioeconomic status (SES) at only 1 point in time, and it is unclear whether changes in neighborhood SES also can influence the risks of CRC.

METHODS

Cox regression analysis was used to examine different trajectories of change in neighborhood SES over 10 years in relation to the incidence of CRC among 266,804 participants (ages 51-70 years) in the National Institutes of Health-AARP Diet and Health Study. Eligible participants reported living in the same neighborhood at baseline (1995-1996) and from 2004 to 2006 according to a follow-up questionnaire. Changes in neighborhood SES were measured between 1990 and 2000 by SES indices derived from Census data. Neighborhoods were grouped into 4 categories based on median SES indices in 1990 and 2000 (low-low, low-high, high-low, and high-high).

RESULTS

Compared with residents whose neighborhoods were in the higher SES group at both time points (reference category), those whose neighborhoods were consistently in the low SES group had a 7% higher risk of developing CRC (hazard ratio, 1.07; 95% confidence interval, 1.00-1.14). Moreover, the risk of CRC was 15% higher (hazard ratio, 1.15; 95% confidence interval, 1.02-1.28) for those living in neighborhoods with decreasing SES (high-low) over time.

CONCLUSIONS

The current findings suggest that exposure to consistently low SES neighborhoods and/or a decrease in neighborhood SES over a period of time may be associated with higher risks of CRC.

Loss of Trust in the Neighborhood: The Experience of Older African Americans in Detroit

Objective

Although evidence suggests that neighborhood conditions are related to stress and health, the processes connecting neighborhood conditions and stress for older minorities is little explored. The purpose of this analysis is to contribute new insights into this issue.

Method

We conducted a qualitative analysis as part of a larger mixed methods study of 100 African Americans aged 55 years and older living in neighborhoods of varying quality in Detroit, Michigan. A subsample of (n = 20) older adults took photographs of bothersome aspects of their neighborhoods and participated in in-depth photo-elicitation interviews. Data were analyzed using a grounded theory approach.

Results

"Loss of trust in the neighborhood" emerged as the core category to explain how older African Americans in our sample experienced neighborhood stressors in their daily lives. Loss of trust in physical, social, and institutional dimensions of the neighborhood contributed to the core category.

Discussion

The life course of neighborhoods and the trust placed in them appears to be intimately connected to the well-being of older African Americans. We therefore hypothesize that a fundamental pathway through which neighborhood stressors are experienced for older African Americans in United States "Rust Belt" cities is the multifaceted loss of trust in the neighborhood.

Neighborhood deprivation and biomarkers of health in Britain: the mediating role of the physical environment

BACKGROUND

Neighborhood deprivation has been consistently linked to poor individual health outcomes; however, studies exploring the mechanisms involved in this association are scarce. The objective of this study was to investigate whether objective measures of the physical environment mediate the association between neighborhood socioeconomic deprivation and biomarkers of health in Britain.

METHODS

We linked individual-level biomarker data from Understanding Society: The UK Household Longitudinal Survey (2010-2012) to neighborhood-level data from different governmental sources. Our outcome variables were forced expiratory volume in 1 s (FEV1%; n=16,347), systolic blood pressure (SBP; n=16,846), body mass index (BMI; n=19,417), and levels of C-reactive protein (CRP; n=11,825). Our measure of neighborhood socioeconomic deprivation was the Carstairs index, and the neighborhood-level mediators were levels of air pollutants (sulphur dioxide [SO2], particulate matter [PM10], nitrogen dioxide [NO2], and carbon monoxide [CO]), green space, and proximity to waste and industrial facilities. We fitted a multilevel mediation model following a multilevel structural equation framework in MPlus v7.4, adjusting for age, gender, and income.

RESULTS

Residents of poor neighborhoods and those exposed to higher pollution and less green space had worse health outcomes. However, only SO2 exposure significantly and partially mediated the association between neighborhood socioeconomic deprivation and SBP, BMI, and CRP.

CONCLUSION

Reducing air pollution exposure and increasing access to green space may improve population health but may not decrease health inequalities in Britain.

Living environment and its relationship to depressive mood: A systematic review

BACKGROUND AND AIMS

The notion that environment affects mental health has a long history; in this systematic review, we aimed to study whether the living environment is related to depressive mood.

METHODS

We searched databases of PubMed, Scopus and Web of Science for population-based original studies prior to October 2016. We included studies that measured depressive symptoms or depression and had measures of urbanization, population density, aesthetics of living environment, house/built environment, green areas, walkability, noise, air pollution or services.

RESULTS

Out of 1,578 articles found, 44 studies met our inclusion criteria. Manual searches of the references yielded 13 articles, resulting in 57 articles being included in the systematic review. Most of the studies showed statistically significant associations with at least one of the characteristics of living environment and depressive mood. House and built environment with, for example, poor housing quality and non-functioning, lack of green areas, noise and air pollution were more clearly related to depressive mood even after adjustment for different individual characteristics. On the contrary, the results in relation to population density, aesthetics and walkability of living environment, and availability of services and depressive mood were more inconsistent.

CONCLUSION

Adverse house/built environment, including poor housing quality and non-functioning, lack of green spaces, noise and air pollution are related to depressive mood and should be taken into account during planning in order to prevent depressive mood.

Individual-level exposure to disaster, neighborhood environmental characteristics, and their independent and combined associations with depressive symptoms in women

PURPOSE

The severity of the stress response to experiencing disaster depends on individual exposure and background stress prior to the event. To date, there is limited research on the interaction between neighborhood environmental stress and experiencing an oil spill, and their effects on depression. The objective of the current study was to assess if the association between exposure to the Deepwater Horizon Oil Spill (DHOS) and depressive symptoms varied by neighborhood characteristics.

METHODS

US Census data (2010) and longitudinal data collected in two waves (2012-2014 and 2014-2016) from female residents [N = 889 (Wave I), 737 (Wave II)] of an area highly affected by the DHOS were analyzed. Multilevel and individual-level negative binomial regressions were performed to estimate associations with depressive symptoms in both waves. An interaction term was included to estimate effect modification of the association between DHOS exposure and depressive symptoms by neighborhood characteristics. Generalized estimating equations were applied to the negative binomial regression testing longitudinal associations.

RESULTS

Census tract-level neighborhood characteristics were not associated with depressive symptoms. Exposure to the DHOS and neighborhood physical disorder were associated with depressive symptoms cross-sectionally. There was no evidence of effect modification; however, physical/environmental exposure to the DHOS was associated with increased depressive symptoms only among women living in areas with physical disorder. Exposure to the DHOS remained associated with depressive symptoms over time.

CONCLUSIONS

Findings support the enduring consequences of disaster exposure on depressive symptoms in women and identify potential targets for post-disaster intervention based on residential characteristics.

Sex differences in the association between area deprivation and generalised anxiety disorder: British population study

OBJECTIVE

Studies have shown that area-level deprivation measured by factors, such as non-home ownership, non-car ownership and household overcrowding, can increase the risk for mental disorders over and above individual-level circumstances, such as education and social class. Whether area-level deprivation is associated with generalised anxiety disorder (GAD) independent of personal circumstances, and whether this association is different between British women and men is unknown.

DESIGN

Large, population study.

SETTING

UK population-based cohort.

PARTICIPANTS

30 445 people from the general population aged 40 years and older and living in England consented to participate at study baseline, and of these, 21 921 participants completed a structured health and lifestyle questionnaire used to capture GAD. Area deprivation was measured in 1991 using Census data, and GAD was assessed in 1996-2000. 10 275 women and 8219 men had complete data on all covariates.

MAIN OUTCOME MEASURE

Past-year GAD defined according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).

RESULTS

In this study, 2.5% (261/10 275) of women and 1.8% (145/8219) of men had GAD. Women living in the most deprived areas were over 60% more likely to develop anxiety than those living in areas that were not deprived (OR=1.63, 95% CI 1.21 to 2.21; p=0.001), but this association between deprivation and GAD was not apparent in men (OR=1.13, 95% CI 0.72 to 1.77; p=0.598).

CONCLUSIONS

The absolute numbers of people living in deprived conditions are large worldwide. This, combined with a growing mental health burden, means that the findings obtained in this study remain highly relevant. The WHO has emphasised the need to reduce social and health inequalities. Our findings provide a strong evidence base to this call, showing that the environment needs to be taken into account when developing mental health policy; gender is important when it comes to assessing the influence of the environment on our mental health.

Understanding Associations Between Neighborhood Socioeconomic Status and Negative Consequences of Drinking: a Moderated Mediation Analysis

We explored how neighborhood socioeconomic status (SES) is related to negative consequences of drinking to explain why racial/ethnic minority group members are more at risk than Whites for adverse alcohol outcomes. We tested direct and indirect effects of neighborhood SES on alcohol problems and examined differences by gender and race. We used data from the 2000 and 2005 National Alcohol Surveys (N = 7912 drinkers aged 18 and older; 49 % female) linked with data from the 2000 Decennial Census in multivariate path models adjusting for individual demographics. In the full sample, neighborhood disadvantage had a significant direct path to increased negative consequences, with no indirect paths through depression, positive affect or pro-drinking attitudes. Neighborhood affluence had significant indirect paths to increased negative consequences through greater pro-drinking attitudes and increased heavy drinking. Subgroup analyses showed the indirect path from affluence to consequences held for White men, with no effects of neighborhood disadvantage. For racial/ethnic minority men, significant indirect paths emerged from both neighborhood disadvantage and affluence to increased consequences through greater pro-drinking attitudes and more heavy drinking. For minority women, there was an indirect effect of neighborhood affluence through reduced depression to fewer drinking consequences. There were limited neighborhood effects on alcohol outcomes for White women. Interventions targeting pro-drinking attitudes in both affluent and disadvantaged areas may help reduce alcohol-related problems among men. Initiatives to improve neighborhood conditions could enhance mental health of minority women and reduce alcohol-related health disparities.

Neighborhood Social Resources and Depressive Symptoms: Longitudinal Results from the Multi-Ethnic Study of Atherosclerosis

The ways in which a neighborhood environment may affect depression and depressive symptoms have not been thoroughly explored. This study used longitudinal data from 5475 adults in the Multi-Ethnic Study of Atherosclerosis to investigate associations of time-varying depressive symptoms between 2000 and 2012 (measured using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D)) with survey-based measures of neighborhood safety and social cohesion (both individual-level perceptions and neighborhood-level aggregates) and densities of social engagement destinations. Linear mixed models were used to examine associations of baseline cross-sectional associations and cumulative exposures with changes over time in CES-D. Econometric fixed effects models were utilized to investigate associations of within-person changes in neighborhood exposures with within-person changes in CES-D. Adjusting for relevant covariates, higher safety and social cohesion and greater density of social engagement destinations were associated with lower CES-D at baseline. Greater cumulative exposure to these features was not associated with progression of CES-D over 10 years. Within-person increases in safety and in social cohesion were associated with decreases in CES-D, although associations with cohesion were not statistically significant. Social elements of neighborhoods should be considered by community planners and public health practitioners to achieve optimal mental health.

Functional Limitations and Gender Differences: Neighborhood Effects

Rates of functional limitations are consistently higher for women than for men, but it is not clear why. While some studies have examined individual risk factors, others have turned to broader social characteristics. We examined the effects of both individual and neighborhood characteristics associated with the functional limitations of older men and women. Multilevel structural equation models were developed using data from a random digit dial sample of 5,688 adults aged 50 to 74 years living in New Jersey. We found that greater numbers of fast-food restaurants, storefronts, and supermarkets was associated with more functional limitations of women, while greater numbers of fast-food restaurants was the only neighborhood characteristic associated with more functional limitations of men. Functional limitations of women, but not men, are affected by multiple neighborhood characteristics. This research reveals that specific neighborhood contextual characteristics, not just poverty, are associated with the health of community-dwelling adults.

Living environment matters: relationships between neighborhood characteristics and health of the residents in a Dutch municipality

Characteristics of an individual alone cannot exhaustively explain all the causes of poor health, and neighborhood of residence have been suggested to be one of the factors that contribute to health. However, knowledge about aspects of the neighborhood that are most important to health is limited. The main objective of this study was to explore associations between certain features of neighborhood environment and self-rated health and depressive symptoms in Maastricht (The Netherlands). A large amount of routinely collected neighborhood data were aggregated by means of factor analysis to 18 characteristics of neighborhood social and physical environment. Associations between these characteristics and self-rated health and presence of depressive symptoms were further explored in multilevel logistic regression models adjusted for individual demographic and socio-economic factors. The study sample consisted of 9,879 residents (mean age 55 years, 48 % male). Residents of unsafe communities were less likely to report good health (OR 0.88 95 % CI 0.80-0.97) and depressive symptoms (OR 0.81 95 % CI 0.69-0.97), and less cohesive environment was related to worse self-rated health (OR 0.81 95 % CI 0.72-0.92). Residents of neighborhoods with more car traffic nuisance and more disturbance from railway noise reported worse mental health (OR 0.79 95 % CI 0.68-0.92 and 0.85 95 % CI 0.73-0.99, respectively). We did not observe any association between health and quality of parking and shopping facilities, facilities for public or private transport, neighborhood aesthetics, green space, industrial nuisance, sewerage, neighbor nuisance or satisfaction with police performance. Our findings can be used to support development of integrated health policies targeting broader determinants of health. Improving safety, social cohesion and decreasing traffic nuisance in disadvantaged neighborhoods might be a promising way to improve the health of residents and reduce health inequalities.

Depression in older cat and dog owners: the Nord-Trøndelag Health Study (HUNT)-3

OBJECTIVE

Depression constitutes a major health problem for older people, in this study defined as people 65 years of age and older. Previous studies have shown that mental health among older people who live with animals could be improved, but contrary results exist as well. Therefore, the objective of the present population study was to compare the self-rated depression symptoms of both female and male non-pet owners, cat owners, and dog owners.

METHOD

The participants in this cross-sectional population study included 12,093 people between the ages of 65 and 101. One thousand and eighty three participants owned cats and 814 participants owned dogs. Self-rated depression symptoms were measured using HADS-D, the scale of self-administered depression symptoms in HADS (Hospital Anxiety and Depression Scale).

RESULTS

The main results showed higher mean values on the HADS-D for cat owners than for both dog and non-pet owners. The latter group rated their depression symptoms the lowest. When dividing the ratings into low- and high-depression symptoms, the logistic regression analysis showed that it was more likely that males who owned cats perceived lower depression symptoms than females who owned cats. No interactions were recognized between pet ownership and subjective general health status, loneliness, or marital status.

CONCLUSIONS

Our results provide a window into the differences in health factors between older females and males who own cats and dogs in rural areas. RESULTS from population studies like ours might increase the available knowledge base when using cats and dogs in clinical environments such as nursing homes.

Social support, collective efficacy, and child physical abuse: does parent gender matter?

Social support and collective efficacy are related to child physical abuse. However, little is known about whether these relationships differ by gender, although mothers and fathers differ in the quantity and quality of time spent with children. This study examined whether the relationship between social support, collective efficacy, and physical abuse is stronger for mothers than fathers. Telephone interviews were conducted with parent respondents in 50 California cities (N = 3,023). Data were analyzed via overdispersed multi-level Poisson models. Results suggest that high levels of emotional support were inversely associated with physical abuse for women and men, although this effect was stronger for women. High levels of companionship support were positively associated with physical abuse for women; however, the opposite was true for men. There were no significant interactions between collective efficacy variables and gender. The relationships between some types of social support and physical abuse appear to vary for men and women suggesting possibilities for more targeted intervention.

Does neighbourhood deprivation cause poor health? Within-individual analysis of movers in a prospective cohort study

BACKGROUND

Neighbourhood deprivation has been associated with poor health. The evidence for social causation, however, remains scarce because selective residential mobility may also create neighbourhood differences. The present study examined whether individuals had poorer health when they were living in a deprived neighbourhood compared to another time when the same individuals were living in a less deprived neighbourhood.

METHODS

Participants were from the British Household Panel Survey prospective cohort study with 18 annual measurements of residential location and self-reported health outcomes between 1991 and 2009 (n=137 884 person-observations of 17 001 persons in England). Neighbourhood deprivation was assessed concurrently with health outcomes using the Index of Multiple Deprivation at the geographically detailed level of Lower Layer Super Output Areas. The main analyses were replicated in subsamples from Scotland (n=4897) and Wales (n=4442). Multilevel regression was used to separate within-individual and between-individuals associations.

RESULTS

Neighbourhood deprivation was associated with poorer self-rated health, and with higher psychological distress, functional health limitations and number of health problems. These associations were almost exclusively due to differences between different individuals rather than within-individual variations related to different neighbourhoods. By contrast, poorer health was associated with lower odds of moving to less deprived neighbourhoods among movers. The analysis was limited by the restricted within-individual variation and measurement imprecision of neighbourhood deprivation.

CONCLUSIONS

Individuals living in deprived neighbourhoods have poorer health, but it appears that neighbourhood deprivation is not causing poorer health of adults. Instead, neighbourhood health differentials may reflect the more fundamental social inequalities that determine health and ability to move between deprived and non-deprived neighbourhoods.

Defining subgroups of low socioeconomic status women at risk for depressive symptoms: the importance of perceived stress and cumulative risks

BACKGROUND

Most disadvantaged women are exposed to risk factors for depression, but not all necessarily have an identical risk for this mental health problem. A better prediction of which low socioeconomic status (SES) women are most at risk for depressive symptoms can help target preventive interventions at high-risk subgroups most in need of support.

AIMS

Exploring which demographic, socioeconomic and psychological risk factors are associated with self-reported depressive symptoms in a sample of low-SES women and whether the number of risk factors might expose them to an accumulated risk.

METHODS

Between April 2005 and November 2007, 519 disadvantaged women from urban neighbourhoods in Maastricht, a southern Dutch city, participated in a cross-sectional survey on stress and depressive symptoms.

RESULTS

Lower education levels, no current employment and lower net monthly family incomes were socioeconomic risk factors associated with higher scores for depressive symptoms. The psychological risk factor 'perceived stress' had the highest explained variance and was most strongly associated with depressive symptoms. Women exposed to multiple risk factors across domains had a cumulated risk for depressive symptomatology.

CONCLUSION

Low-SES women who seem most eligible for targeted preventive action are those with cumulative risks. Depression prevention strategies for this population may benefit from focusing on perceived stress since this is an important modifiable risk factor.

Are neighborhood health associations causal? A 10-year prospective cohort study with repeated measurements

People who live in disadvantaged neighborhoods tend to have poor physical and mental health, but this might be due to selective residential mobility rather than causal neighborhood effects. As a test of social causation, I examined whether persons were less healthy when they were living in disadvantaged neighborhoods than at other times when they were living in more advantaged neighborhoods. Data were taken from the 10-year Household, Income and Labour Dynamics in Australia (HILDA) prospective cohort study, which had annual follow-up waves between 2001 and 2010 (n = 112,503 person-observations from 20,012 persons). Neighborhood disadvantage was associated with poorer self-rated health, mental health, and physical functioning, higher probability of smoking, and less frequent physical activity. However, these associations were almost completely due to between-person differences; the associations were not replicated in within-person analyses that compared the same persons living in different neighborhoods over time. Results were similar when using neighborhood remoteness as the exposure and when focusing only on long-term residence. In contrast, poor health predicted selective residential mobility to less advantaged neighborhoods, which provided evidence of social selection. These findings provide little support for social causation in neighborhood health associations and suggest that correlations between neighborhoods and health may develop via selective residential mobility.

Cohort Profile: The Montreal Neighbourhood Networks and Healthy Aging (MoNNET-HA) study

The Montreal Neighbourhood Networks and Healthy Aging study was established: (i) to assess the added value in using formal network methods and instruments to measure social capital and its relationship to health; (ii) to determine whether older adults are more vulnerable to the effects of network and neighbourhood environments; and (iii) to examine longitudinally the relationship between social capital and health among adults in Montreal, Canada. The MoNNET-HA cohort consists of men and women aged 25 years and older, residing in the Montreal Metropolitan Area (MMA). Participants were recruited using a random stratified cluster sampling design with oversampling of adults older than 65 years. Initial MoNNET-HA study participants (n = 2707) were recruited for telephone interviews in the summer of 2008. Since 2008, participants were interviewed in the autumn of 2010 and the winter of 2013/2014. Data currently fall into five categories: (i) social network and social capital; (ii) psychosocial and psychological; (ii) socio-demographic and socioeconomic; (iv) health behaviours and conditions; and (v) neighbourhood environmental characteristics. Healthcare utilization data will be available for a subsample of participants. Upon funding, future work will measure anthropometric and metabolic health directly. Based on agreements with participants, external researchers should request access to data via collaborations with the study group.