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Neighbourhood environment and the incidence of depressive symptoms among middle-aged African Americans
  1. Mario Schootman1,
  2. Elena M Andresen2,
  3. Fredric D Wolinsky3,
  4. Theodore K Malmstrom4,
  5. J Philip Miller5,
  6. Douglas K Miller6
  1. 1Department of Medicine and Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
  2. 2Department of Epidemiology and Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
  3. 3Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa, USA
  4. 4Department of Psychiatry, School of Medicine, Saint Louis University, St Louis, Missouri, USA
  5. 5Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri, USA
  6. 6Indiana University Center for Aging Research, Regenstrief Institute for Health Care, Indiana University School of Medicine, Indianapolis, Indiana, USA
  1. Correspondence to:
 Dr M Schootman
 Washington University, Division of Health Behavior Research, 4444 Forest Park Blvd, Box 8504, St Louis, MO 63108, USA; mschootm{at}


Aim: To investigate the association between attributes of subject location and incidence of clinically relevant levels of depressive symptoms (CRLDS), and to investigate whether an association remained after adjusting for individual-level factors using data from the population-based African American Health Study.

Methods: An 11-item depression scale (Center for Epidemiologic Studies Depression scale) was obtained at baseline and 3 years later through in-home evaluations. Census tract and block group deprivation indices were obtained from the 2000 census. The external appearance of the block where the subject lived was rated during sample enumeration, and the interior and exterior of the subject’s dwelling were observed during the initial in-home interview.

Results: Of 998 subjects at baseline, 21.1% had CRLDS. Although 12.7% of the 672 people without CRLDS at baseline developed them by the 3-year follow-up, univariate and propensity-adjusted analyses revealed no association between the subject’s location and the incidence of CRLDS. Sensitivity analyses confirmed the robustness of the findings.

Conclusion: Despite other studies showing independent effects of neighbourhood characteristics on the prevalence of CRLDS, attributes of subject location are not independent contributors to the incidence of CRLDS in middle-aged urban African Americans.

  • CES-D, Center for Epidemiologic Studies Depression
  • CRLDS, clinically relevant levels of depressive symptoms
  • LBFL, lower-body functional limitations

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  • Competing interests: None declared.

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