Background Residents of disadvantaged neighbourhoods report higher levels of depressive symptoms; however, few studies have employed prospective designs during adolescence, when depression tends to emerge. We examined associations of neighbourhood social fragmentation, income inequality and median household income with depressive symptoms in a nationally representative survey of adolescents.
Methods The NEXT Generation Health Study enrolled 10th-grade students from 81 US high schools in the 2009–2010 school year. Depressive symptoms were assessed with the Modified Depression Scale (wave 1) and the paediatric Patient-Reported Outcome Measurement Information System (waves 2–6). Neighbourhood characteristics at waves 1, 3, 4, and 5 were measured at the census tract level using geolinked data from the American Community Survey 5-year estimates. We used linear mixed models to relate neighbourhood disadvantage to depressive symptoms controlling for neighbourhood and individual sociodemographic factors.
Results None of the models demonstrated evidence for associations of social fragmentation, income inequality or median household income with depressive symptoms.
Conclusion Despite the prospective design, repeated measures and nationally representative sample, we detected no association between neighbourhood disadvantage and depressive symptoms. This association may not exist or may be too small to detect in a geographically dispersed sample. Given the public health significance of neighbourhood effects, future research should examine the developmental timing of neighbourhood effects across a wider range of ages than in the current sample, consider both objective and subjective measures of neighbourhood conditions, and use spatially informative techniques that account for conditions of nearby neighbourhoods.
- social epidemiology
- longitudinal studies
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Contributors Study concept and design: RBG, AKL and SEG. Drafting of the manuscript: RBG. Acquisition, analysis or interpretation of data; critical revision of the manuscript for important intellectual content; approval of submission and accountability for all aspects of the work in ensuring that any questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: All authors.
Funding This research (contract number HHSN275201200001I) was supported in part by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, and Maternal and Child Health Bureau of the Health Resources and Services Administration, with supplemental support from the National Institute on Drug Abuse.
Disclaimer The views, opinions and assertions expressed in this report are those of the authors and should not be construed to represent the views or the official policy or position of any of the sponsoring organisations or agencies or the US government, including the Uniformed Services University or the Department of Defense.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data from the Next Generation Health Study are available through the Data and Specimen Sharing Hub (DASH), a centralized data resource for researchers to access data from research studies funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development for use in secondary research. For further information, please visit: https://dash.nichd.nih.gov/
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