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Are Neighborhood Characteristics Associated with Depressive Symptoms? A Critical Review
  1. Christina F Mair,
  2. Ana V Diez Roux,
  3. Sandro Galea
  1. University of Michigan, United States
  1. E-mail: adiezrou{at}umich.edu

Abstract

Study objective: To conduct a review of published observational studies of neighborhoods and depression/depressive symptoms to inform future directions for the field.

Design: We reviewed 45 English-language cross-sectional and longitudinal studies that analyzed the effect of at least one neighborhood-level variable on either depression or depressive symptoms.

Main results: Of the 45 studies, 37 reported associations of at least one neighborhood characteristic with depression/depressive symptoms. Seven of the ten longitudinal studies reported associations of at least one neighborhood characteristic with incident depression. Socioeconomic composition was the most common neighborhood characteristic investigated. The associations of depressive symptoms/depression with structural features (socioeconomic and racial composition, stability, and built environment) were less consistent than with social processes (disorder, social interactions, violence). Among the structural features, measures of the built environment were the most consistently associated with depression but the number of studies was small.

Conclusions: The extent to which these associations reflect causal processes remains to be determined. The large variability in studies across neighborhood definitions and measures, adjustment variables and study populations makes it difficult to draw more than a few general qualitative conclusions. Improving the quality of observational work though improved measurement of neighborhood attributes, more sophisticated consideration of spatial scale, longitudinal designs, and evaluation of natural experiments will strengthen inferences regarding causal effects of area attributes on depression.

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