Neighbourhood characteristics, individual level socioeconomic factors, and depressive symptoms in young adults: the CARDIA study
- Claire Henderson1,
- Ana V Diez Roux2,
- David R Jacobs, Jr3,
- Catarina I Kiefe4,
- Delia West5,
- David R Williams6
- 1Health Services Research Department, Institute of Psychiatry, London, UK
- 2University of Michigan Center for Social Epidemiology and Population Health, USA
- 3Division of Epidemiology, School of Public Health, University of Minnesota, USA and Department of Nutrition, University of Oslo, Oslo, Norway
- 4Division of Preventive Medicine, University of Alabama at Birmingham, and Birmingham Veterans Affairs Medical Center, USA
- 5University of Arkansas Medical Sciences, USA
- 6University of Michigan Institute for Social Research, USA
- Correspondence to: Dr C Henderson Public Psychiatry Fellowship, room 317, 722 W 168th Street, New York, NY 10032, USA;
- Accepted 30 July 2004
Study objective: To investigate the relation between neighbourhood socioeconomic and ethnic characteristics with depressive symptoms in a population based sample.
Design: Cross sectional data from the CARDIA study, including the Center for Epidemiological Studies depression scale score (CES-D). Neighbourhoods were 1990 US census blocks of 1000 people; six census variables reflecting wealth/income, education, and occupation investigated separately and as a summary score; neighbourhood racial composition (percentage white and black) and individual level income and education were also examined.
Setting: Participants recruited in 1985/86 from community lists in Birmingham, AL; Chicago, IL; Minneapolis MN; from a health plan in Oakland, CA.
Participants: 3437 adults aged 28–40 years in 1995/96: 24% white men, 27% white women, 20% black men, 29% black women.
Main results: For each race-sex group, CES-D was inversely related to neighbourhood score and individual income and education. Associations of neighbourhood score with CES-D became weak and inconsistent after adjusting for individual level factors; personal income remained strongly and inversely associated with CES-D. Age adjusted mean differences (standard errors) in CES-D between the lowest and highest income categories were 3.41 (0.62) for white men, 4.57 (0.64) for white women, 5.80 (0.87) for black men, and 5.74 (0.83) for black women. For both black and white participants, CES-D was associated negatively with percentage of white people and positively with percentage of black people in their census block, before, but not after, adjustment for individual and neighbourhood socioeconomic variables.
Conclusions: Neither neighbourhood socioeconomic characteristics nor ethnic density were consistently related to depressive symptoms once individual socioeconomic characteristics were taken into account.
- CARDIA, coronary artery risk development in young adults study
- CES-D, Center for Epidemiological Studies depression scale
Funding: this work was supported in part by grant MD00206 P60 (Dr Diez Roux) from NCMH (NIH). The CARDIA study was supported by NHLBI contracts N01-HC-48047, N01-HC-48048, N01-HC-48049, N01-HC-48050 and N01-HC-95095. We also wish to acknowledge support from the MacArthur Network on Socioeconomic Factors and Health.
Competing interests: none declared.