Journal
HEALTH & PLACE
Volume 62, Issue -, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.healthplace.2019.102278
Keywords
Depression; Neighborhoods; Mediation; Loneliness; Older adults
Categories
Funding
- Association of Schools of Public Health
- Centers for Disease Control and Prevention [U01 DP003206, U01 DP006266, S043, S1734, S3486]
- National Institute of Arthritis and Musculoskeletal and Skin Diseases [RO1 AR053898-P60 AR30701, P60 AR049465, P60 AR064166]
- University of North Carolina at Chapel Hill Graduate School
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Few studies have documented the pathways through which individual level variables mediate the effects of neighborhoods on health. This study used structural equation modeling to examine if neighborhood characteristics are associated with depressive symptoms, and if so, what factors mediated these relationships. Crosssectional data came from a sample of mostly rural, older adults in North Carolina (n = 1,558). Mediation analysis indicated that associations among neighborhood characteristics and depressive symptoms were mediated by loneliness (standardized indirect effect = -0.19, p < 0.001), physical activity (standardized indirect effect = -0.01, p = 0.003), and perceived individual control (standardized indirect effect = -0.07, p = 0.02) with loneliness emerging as the strongest mediator. Monitoring such individual mediators in formative and process evaluations may increase the precision of neighborhood-based interventions and policies.
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