Journal
ANNALS OF EPIDEMIOLOGY
Volume 19, Issue 1, Pages 49-57Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.annepidem.2008.10.002
Keywords
Mental Health; Depression; Residence Characteristics; Epidemiology; Social Environment
Categories
Funding
- National Heart, Lung, and Blood Institute [N01-HC-95159-95165]
- [R01 HL071759]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R21HL095165, R01HL071759] Funding Source: NIH RePORTER
- National Institute on Minority Health and Health Disparities [P60MD002249] Funding Source: NIH RePORTER
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PURPOSE: This study examined associations of neighborhood social cohesion, violence, and aesthetic quality with depressive symptoms among 2,619 healthy adults aged 45-84 years enrolled in the Multiethnic Study of Atherosclerosis. METHODS: Neighborhood characteristics were estimated by surveying a separate sample of area residents. Measures of aesthetic environment, social cohesion, and violence were combined into a summary score with increasing scores indicating more favorable environments. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression (CES-D) scale. Marginal maximum likelihood estimation was used to assess associations of neighborhood characteristics with CES-D score at baseline and with the odds of developing incident depression (CES-D score >= 16 or use of antidepressants) over a 4-5 year follow-up among persons with CES-D less than 16 at baseline. Models were adjusted for age, income, education, and race/ethnicity. RESULTS: Lower levels of social cohesion and aesthetic quality and higher levels of violence were associated with higher mean CES-D scores in men and women (P for trend < 0.01, adjusted mean difference in CES-D per 1 SD increase in summary score -1.01 [95% confidence interval = -1.85, -0.17] and -1.08 [95% confidence interval,= -1.88, -0.28] in men and women, respectively). Associations of neighborhood characteristics with incident depression were in the expected direction for women but confidence intervals were wide (odds ratio of incident depression = 0.89 [0.63, 1.26]). No association was seen for men (odds ratio = 0.96 [0.74, 1.25]). CONCLUSION: Neighborhood social cohesion, aesthetic quality, and violence are associated with the presence of depressive symptoms in residents.
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