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Social isolation has been implicated in the development of cognitive impairment, but research on this association remains limited among racial-ethnic minoritized populations. Our study examined the interplay between social isolation, race–ethnicity and dementia.
Methods
We analyzed 11 years (2011–2021) of National Health and Aging Trends Study (NHATS) data, a prospective nationally representative cohort of U.S. Medicare beneficiaries aged 65 years and older. Dementia status was determined using a validated NHATS algorithm. We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling respondents. Cox regression determined how the interaction between social isolation and race–ethnicity was associated with incident dementia risk.
Results
Average longitudinal frequency of social isolation was higher among older Black (27.6%), Hispanic (26.6%) and Asian (21.0%) respondents than non-Hispanic White (19.1%) adults during the 11-year period (t = −7.35, p < .001). While a higher frequency of social isolation was significantly associated with an increased (approximately 47%) dementia risk after adjusting for sociodemographic covariates (adjusted hazard ratio [aHR] = 1.47, 95% CI [1.15, 1.88], p < .01), this association was not significant after adjusting for health covariates (aHR = 1.21, 95% CI [0.96, 1.54], p = .11). Race–ethnicity was not a significant moderator in the association between social isolation and dementia.
Conclusions
Older adults from racial-ethnic minoritized populations experienced a higher longitudinal frequency of social isolation. However, race–ethnicity did not moderate the positive association observed between social isolation and dementia. Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities in social isolation and to develop targeted interventions to mitigate the associated dementia risk.
Antisocial behaviour arises from a complex interplay of innate and environmental factors, with the brain’s adaptability to shifting environmental demands playing a pivotal role. An important but scantly studied environmental factor – micro-geographic hot spots of crime – covers a broad array of problems that produce frequent triggers for antisocial behaviour. Despite the established influence of neural substrates and various environmental factors on antisocial behaviour, the impact of residing in high-risk, violent crime hot spots in Israel, as well as other global locales, remains understudied. This paper aims to elucidate the intricate interplay between neurobiological mechanisms and crime hot spots in the context of antisocial behaviour. Its objectives are twofold: first, to acquaint researchers with the existing literature on the subject; and second, to catalyse further research and robust discourse in this domain. The article commences by reviewing the behavioural manifestations of antisocial tendencies within the framework of crime hot spots. Subsequently, it delves into the influence of crime hot spots on neurocognitive substrates, particularly emphasizing their impact on developmental trajectories associated with antisocial tendencies and the expression of antisocial behaviours. In closing, the paper offers implications and conclusions pertinent to crime hot spots in Israel.
This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.
The psychoactive properties of cannabis have been known forever. Since 1987, several prospective studies have suggested an increased risk of psychosis among cannabis users, with alternative explanations failing to account for such an effect. A cause–effect relationship has thus been implied. Further evidence has indicated that there is a dose–response relationship, and high-potency cannabis varieties confer the greatest risk of psychosis. As cannabis use has become more common over the last decades, one would expect a related increase in the number of schizophrenia cases. However, evidence in this regard remains equivocal for several reasons, including relying on databases that are not primarily designed to address such question and the issue that solid information regarding the incidence of schizophrenia is a relatively recent acquisition. Recent years have seen the development of online web publications, such as Google Trends and “Our World in Data”, where data are explorable and interactable for tracking and comparing trends over specific periods and world regions. By using such databases, we believe that the question whether changes in cannabis use are associated with changes in schizophrenia rates can be answered, at least partly. Therefore, we tested these tools by evaluating trends in cannabis use and both cases and prevalence of schizophrenia in the United Kingdom, one of the countries where the incident rates for psychotic disorder have been suggested to be particularly increased by cannabis consumption. Crossing data from these tools revealed that interest in cannabis has been growing at the country level for over 10 years, with a parallel overlapping raise in psychosis cases and prevalence. Following up on this example, let us think of how many public health opportunities these public resources may offer. The question now is whether public health interventions for the benefit of the general population will follow suit.
Children of incarcerated mothers are at increased risk of experiencing multiple adversity such as poverty, mental illness and contact with child protection services (CPS), including being taken into out of home care (OOHC). However, little is known about whether these children are at increased risk of suicide or self-harm compared to children not exposed to maternal incarceration or about the factors that may contribute to this. We aimed to investigate differences in the risk of suicide and self-harm between children exposed to maternal incarceration and those not exposed and examine how socio-demographic factors, maternal mental illness and CPS contact (with or without OOHC) may affect these outcomes.
Methods
We used a retrospective matched cohort study design, comparing 7674 children exposed to maternal incarceration with 7674 non-exposed children. We used multivariable Cox proportional hazards regression to compare the risk of suicide and self-harm between exposed and non-exposed groups, controlling for geographical remoteness, CPS contact and maternal mental illness.
Results
There was no significant difference in the rate of suicide (rate ratio [RR] = 1.49; 95% confidence interval [CI]: 0.78, 2.87) or risk of suicide (adjusted hazard ratio [aHR] = 0.92; 95% CI: 0.43, 1.96) between the two groups. However, the exposed group had a significantly higher rate of self-harm (RR = 2.83; 95% CI: 2.50, 3.21) and a significantly higher risk of self-harm (aHR = 1.74; 95% CI: 1.45, 2.09) compared to those non-exposed. CPS contact with or without OOHC was independently associated with an increased risk of self-harm for both groups.
Conclusion
Children exposed to maternal incarceration are at an increased risk of self-harm and should be prioritized to receive targeted, multimodal support that continues after the mother’s release from prison. The association between CPS contact and self-harm warrants further research.
Knowledge on the link of individual social deprivation with dementia is incomplete. We thus aimed to see whether an association with dementia risk can be observed using a recently developed Social Deprivation Index (SoDep Index). Further, as deprivation is related to depression, we investigated the role of depression in the association.
Methods
We analysed data of 11 623 Survey of Health, Ageing and Retirement in Europe (SHARE) respondents. Social deprivation status was determined by SoDep Index score. Dementia was determined by self-reported diagnosis. Dementia risk by social deprivation status was estimated using Cox proportional hazard models, including relevant covariates (gender, marriage status, chronic conditions). Depressive symptom status was added in a second step. Further, we completed subgroup analyses by social deprivation status and analysed the relevance of depressive symptoms in dementia risk in each deprivation group. In an additional sensitivity analyses we corrected for mortality and used impaired cognitive testing performance as an alternative outcome.
Results
High (v. low) social deprivation status was associated with an increased dementia risk (hazard ratio (HR) = 1.79 [95% CI 1.31–2.45]) in the Cox analysis adjusted for covariates only. Further adjustment for depressive symptom status indicated a largely direct association between social deprivation status and dementia risk. Moreover, compared to not having experienced depressive symptoms in the past or at baseline, those with past (HR = 1.67 [95% CI 1.23–2.25]), baseline (HR = 1.48 [95% CI 1.04–2.10]) or stable depressive symptoms (HR = 2.96 [95% CI 2.12–4.14]) had an increased dementia risk. The association between stable depressive symptom status and dementia risk was in the high social deprivation subgroup particularly pronounced. Sensitivity analyses replicated results.
Conclusions
Results add to a growing body of evidence indicating that a public health approach to dementia prevention must address socioeconomic inequity. Results suggest a largely direct association between social deprivation and dementia risk. Adults who experience high social deprivation appear particularly affected by detrimental effects of depressive symptomatology on dementia risk and need intervention.
Not only is nature essential for human existence, but many of its functions and contributions are irreplaceable. Studying the impact of these changes on individuals and communities, researchers and public health officials have largely focused on physical health. Our aim is to better understand how climate change also exacerbates many social and environmental risk factors for mental health and psychosocial problems, and can lead to emotional distress, the development of new mental health conditions and a worsening situation for people already living with these conditions.
Methods
We considered all possible direct and indirect pathways by which climate change can affect mental health. We built a framework which includes climate change-related hazards, climate change-related global environmental threats, social and environmental exposure pathways, and vulnerability factors and inequalities to derive possible mental health and psychosocial outcomes.
Results
We identified five approaches to address the mental health and psychosocial impacts of climate change which we suggest should be implemented with urgency: (1) integrate climate change considerations into policies and programmes for mental health, to better prepare for and respond to the climate crisis; (2) integrate mental health and psychosocial support within policies and programmes dealing with climate change and health; (3) build upon global commitments including the Sustainable Development Goals, the Paris Agreement and the Sendai Framework for Disaster Risk Reduction; (4) implement multisectoral and community-based approaches to reduce vulnerabilities and address the mental health and psychosocial impacts of climate change; and (5) address the large gaps that exist in funding both for mental health and for responding to the health impacts of climate change.
Conclusions
There is growing evidence of the various mechanisms by which climate change is affecting mental health. Given the human impacts of climate change, mental health and psychosocial well-being need to be one of the main focuses of climate action. Therefore, countries need to dramatically accelerate their responses to climate change, including efforts to address its impacts on mental health and psychosocial well-being.
Many people with anxiety do not seek therapy due to negative views of treatment. Although close others (e.g. romantic partners, family members, close friends) are highly involved in treatment decisions, the role of specific relational behaviours in treatment ambivalence has yet to be studied.
Aims:
This study examines the relationship between social predictors (perceived criticism and accommodation of anxiety symptoms by close others) and treatment ambivalence.
Method:
Community members who met diagnostic criteria for an anxiety-related disorder (N = 65) and students who showed high levels of anxiety (N = 307) completed an online study. They were asked to imagine they were considering starting cognitive behavioural therapy (CBT) for their anxiety and complete a measure of treatment ambivalence accordingly. They then completed measures of perceived criticism and accommodation by close others. Linear regression was used to examine the predictive value of these variables while controlling for sample type (clinical/analogue) and therapy experience.
Results:
Greater reactivity to criticism from close others and greater accommodation of anxiety symptoms by close others were associated with greater treatment ambivalence in those with anxiety. These predictors remained significant even when controlling for therapy history and sample type.
Conclusions:
When it comes to treatment attitudes, relational context matters. Clients demonstrating ambivalence about starting therapy may benefit from discussion about the impact of their social environment on ambivalence.
Immune system aging, a process known as immunosenescence, involves a striking rearrangement affecting all immune cells, resulting in an increased rate of infections and a major incidence of autoimmune diseases and cancer. Nonetheless, differences in how individuals of the same chronological age carry out this immunosenescence establishment and thus the aging rate have been reported. In the context of neuroimmunoendocrine communication and its role in the response to stress situations, growing evidence suggests that social environments profoundly influence all physiological responses, especially those linked to immunity. Accordingly, negative contexts (loneliness in humans/social isolation in rodents) were associated with immune impairments and decreased lifespan. However, positive social environments have been correlated with adequate immunity and increased lifespan. Therefore, the social context in which an individual lives is proposed as a decisive modulator of the immunosenescence process and, consequently, of the rate of aging. In this review, the most important findings regarding how different social environments (negative and positive) modulate immunosenescence and therefore the aging rate, as well as the role of stress responses, hormesis, and resilience in these environments will be explained. Finally, several possible molecular mechanisms underlying the effects of negative and positive environments on immunosenescence will be suggested.
Children's responses to war and displacement are varied; many struggle, while others appear resilient. However, research into these outcomes disproportionately focuses on cross-sectional data in high-income countries. We aimed to (1) investigate change in resilience across two timepoints in a highly vulnerable sample of Syrian refugee children in Lebanon, and (2) explore predictors of their mental health problems across time.
Methods
In total, 982 Syrian child–caregiver dyads living in refugee settlements in Lebanon completed questionnaires via interview at baseline and follow-up one year later. We categorised children into groups based on their risk for mental health problems across both timepoints (stable high risk/SHR, deteriorating, improving, stable low risk) according to locally validated cut-offs on measures of post-traumatic stress disorder (PTSD), depression and behavioural problems. Analyses of covariance identified how the groups differed on a range of individual and socio-environmental predictors, followed up by cross-lagged panel models (CLPMs) to investigate the directionality of the relationships between significantly related predictors and symptoms.
Results
The sample showed a meaningful amount of change in mental health symptoms from baseline to follow-up. Over half (56.3%) of children met SHR criteria and 10.3% deteriorated over time, but almost one-quarter (24.2%) showed meaningful improvement, and 9.2% were consistently at low risk for mental health problems at both timepoints. Several predictors differentiated the groups, particularly social measures. According to CLPMs, maternal acceptance (β = −0.07) predicted child mental health symptoms over time. Self-esteem (β = −0.08), maternal psychological control (β = 0.10), child maltreatment (β = 0.09) and caregiver depression (β = 0.08) predicted child symptoms and vice versa (βse = −0.11, βb = 0.07, βmpc = 0.08, βcm = 0.1, βcd = 0.11). Finally, child symptoms predicted loneliness (β = 0.12), bullying (β = 0.07), perceived social support (β = −0.12), parent–child conflict (β = 0.13), caregiver PTSD (β = 0.07), caregiver anxiety (β = 0.08) and the perceived refugee environment (β = −0.09).
Conclusions
Our results show risk and resilience are dynamic, and the family environment plays a key role in children's response to war and displacement. Conversely, children also have a significant impact on the family environment and caregiver's own mental health. Interventions to promote resilience in refugee children should therefore consider family-wide mechanisms.
The prevalence of overweight in Brazilian adults has grown in recent years. There is evidence indicating that environmental factors, especially social characteristics, may be involved in the aetiology of overweight, but few studies have investigated this association adequately. The main objective of this study was to identify residents’ perception of their social environment (social cohesion, security and violence) and assess its relationship with overweight in a central area of Porto Alegre, Brazil. The associations between socioeconomic characteristics and social environment perception were also explored. This cross-sectional study conducted in 2018–19 had 400 participants aged from 20 to 70 years living in low- and high-income areas of the city of Porto Alegre. Participants’ perception of social cohesion, security and violence were evaluated using a validated questionnaire. Participants’ body mass index (BMI) was measured, and those with a BMI ≥25 kg/m2 were considered to be overweight. Unadjusted and adjusted prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were estimated through Poisson regression analysis; level of significance was 5%. The prevalence of overweight in the sample was 68.8% (95% CI 64.0–73.2). Individuals with a more positive social cohesion perception had a higher prevalence of overweight (PR 1.06; 95% CI: 1.00–1.12; p=0.02) than those with a less positive perception. Brown individuals also had a higher prevalence of overweight (PR: 1.08; 95% CI: 1.02–1.15; p=0.03) than those of other skin colour/race. No association was found between overweight and perception of security or violence. Therefore, social cohesion may be an important factor in overweight and the findings highlight the importance of considering social factors, and their perceptions, when planning actions for the prevention and control of overweight in a population.
The mental health of individuals who have been forcibly displaced can be impacted both by war-related traumatic events and displacement-related stressors, which arise as a consequence of their migratory journey and subsequent experiences. In addition to focusing on mental disorders, there is a need to explore broader psychosocial outcomes that are important for forcibly displaced people. Our aim is to present a coherent explanatory framework to understand how both past traumatic events and ongoing stressors operating throughout forcibly displaced people's social environment can impact mental health and psychosocial wellbeing.
Methods
We describe the capability approach (CA), a human development framework that foregrounds individuals’ freedom to engage in forms of being and doing that are valuable to them. We consider the opportunities that the CA provides for understanding how a myriad of factors can impact forcibly displaced people, and how different forms of support can be configured to meet the needs of particular people and communities.
Results
The CA recognises that various factors can share a common putative causal mechanism in their impact on forcibly displaced people, i.e. these factors limit a person's ability to develop capabilities and their freedom to engage in valued forms of being and doing. The rights based ethos of the CA enables multisectoral and coordinated activity, which can be directed towards addressing factors across the social environment. Importantly, the CA helps to explain why particular forms of support may be more beneficial for individuals or communities at certain times compared to others.
Conclusion
The application of the CA can help to guard against the risk that the aspirations of assessment instruments and interventions aimed at supporting forcibly displaced people are narrowly focused on addressing distress and disorders, to instead adopt a more expansive focus on forcibly displaced people's potential and the possibilities that they wish to realise.
Research shows that healthy ageing is defined differently by older adults and researchers, who may put more or less weight on the physiological, psychological, societal and personal aspects of ageing. Although there is growing interest in the research literature on lay models of healthy ageing in socio-cultural context, little work has been done to determine how important or feasible the various components of healthy ageing are viewed to be by older adults. This study asked a convenience sample of 54 older adults in the circumpolar North to rate the importance and feasibility of 36 previously identified components of healthy ageing in their community. Results indicate that seniors in the sample place the most importance on aspects of the social and physical environment, while least important concepts included psychological and individual behaviours. However, most feasible aspects were individual behaviours and least feasible were aspects of the social and physical environment. Although older adults are able to construct a model of what healthy ageing should look like in their community, they do not always view the most important aspects of healthy ageing to be the most feasible to achieve, providing ample opportunity for public and social policy change.
To investigate behavioural problems throughout childhood and adolescent, and its relationship with socioeconomic position (SEP) and early parenting environment.
Methods
Using data from the Millennium Cohort Study conducted in the UK, behavioural problems of 14 452 children were analysed using a growth curve model. The children were followed from birth to adolescence, and their behavioural problems were measured by the Strengths and Difficulties Questionnaire (SDQ). The SDQ was sub-scaled into externalising and internalising problems. After assessing the general trajectory of children's behavioural problems, variables representing SEP and parenting environments were introduced to the model to analyse the association with children's outcomes.
Results
Overall, children's trajectories in externalising problems showed a decreasing trend while internalising problems increased as they aged. Household income and maternal education in early childhood were independently associated with children's behavioural problems, while the association for maternal occupation was significantly weaker. Positive early parenting environments attenuated the association between SEP and children's behavioural problems. Also, with regards to children's behavioural problems, positive parenting explained more variance between children compared to SEP. Favourable parent–child relationship buffered the income gradient in children's behavioural problems during early childhood, and although this buffering effect did not last until adolescence, those who had good parent–child relationships developed better outcomes regardless of their SEP.
Conclusions
The results of the study emphasise the importance of a positive early parenting environment for improving and reducing the socioeconomic gap in children's behavioural problems and encourages policies to promote better parenting circumstances.
Previous studies have shown an elevated risk of psychotic symptoms (PS) and experiences (PEs) among ethnic minority groups, with significant variation between groups. This pattern may be partially attributable to the unfavorable socio-environmental conditions that surround ethnic minority groups. Perceived ethnic discrimination (PED) in particular has been a salient putative risk factor to explain the increased risk.
Methods
We conducted a systematic literature review and meta-analysis to assess the impact of PED on reporting PS/PEs in ethnic minorities. This review abides by the guidelines set forth by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The included studies were obtained from the databases: Medline, PsycINFO, and Web Of Science. Sub-group analyses were performed assessing the effect of PED in different subtypes of PS, the influence of ethnicity and moderating/mediating factors.
Results
Seventeen studies met the inclusion criteria, and nine were used to conduct the meta-analysis. We found a positive association between PED and the occurrence of PS/PEs among ethnic minorities. The combined odds ratio were 1.77 (95% CI 1.26–2.49) for PS and 1.94 (95% CI 1.42–2.67) for PEs. We found that the association was similar across ethnic groups and did not depend on the ethnic origin of individuals. Weak evidence supported the buffering effects of ethnic identity, collective self-esteem and social support; and no evidence supported the moderating effect of ethnic density. Sensitivity to race-based rejection significantly but only slightly mediated the association.
Conclusion
These findings suggest that PED is involved in the increased risk of PS/PEs in ethnic minority populations.
Relationships are embedded in broader social networks, including the family and friends of both partners. Covering contributions from several disciplines, this chapter discusses the role of social networks in the maintenance of intimate relationships. We first describe findings from the communication field showing how people use their social networks (such as through doing activities with mutual friends) as one of several strategies to maintain their relationships. Then, we discuss social psychological literature regarding how social networks affect both dyad members’ motivation to engage in various maintenance mechanisms that follow from their decision to commit. Furthermore, the social network can be instrumental in influencing pair members’ ability to maintain their relationship, including by giving advice to help repair relationships, which is also discussed in this chapter. We then turn to more macro-level issues regarding the compositional or structural dimensions of social networks and the ways in which they play a role in the maintenance of couples’ relationships. Variation in the processes of network influence on the maintenance of relationships is also considered, including how networks differentially influence relationship maintenance across the life course and through technology (e.g., social media).
Proximal environments could facilitate smoking cessation among low-income smokers by making cessation appealing to strive for and tenable.
Aims
We sought to examine how home smoking rules and proximal environmental factors such as other household members' and peers' smoking behaviors and attitudes related to low-income smokers' past quit attempts, readiness, and self-efficacy to quit.
Methods
This analysis used data from Offering Proactive Treatment Intervention (OPT-IN) (randomized control trial of proactive tobacco cessation outreach) baseline survey, which was completed by 2,406 participants in 2011/12. We tested the associations between predictors (home smoking rules and proximal environmental factors) and outcomes (past-year quit attempts, readiness to quit, and quitting self-efficacy).
Results
Smokers who lived in homes with more restrictive household smoking rules, and/or reported having ‘important others’ who would be supportive of their quitting, were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting.
Conclusions
Adjustments to proximal environments, including strengthening household smoking rules, might encourage cessation even if other household members are smokers.
Current understanding of psychosis development is relevant to patients' clinical outcomes in mental health services as a whole, given that psychotic symptoms can be a feature of many different diagnoses at different stages of life. Understanding the risk factors helps clinicians to contemplate primary, secondary and tertiary preventive strategies that it may be possible to implement. In this second article of a three-part series, the psychosis risk timeline is again considered, here focusing on risk factors more likely to be encountered during later childhood, adolescence and adulthood. These include environmental factors, substance misuse, and social and psychopathological aspects.
LEARNING OBJECTIVES:
After reading this article you will be able to:
• understanding the range of risk factors for development of psychotic symptoms in young people and adults
• understand in particular the association between trauma/abuse and subsequent psychosis
• appreciate current evidence for the nature and strength of the link between substance misuse and psychosis.
Most older Canadians do not engage in sufficient physical activity. There is an urgent need for outside-the-box strategies that encourage and sustain active lifestyles. Video is a promising knowledge translation (KT) tool to engage diverse audiences in discussion and action around health promoting behaviours. We adopted a KT framework to inform a structured process of video development we have named systematic approach to evidence-informed video (SAEV). This guided the creation and dissemination of a 19-minute documentary video: I’d Rather Stay (https://vimeo.com/80503957). Following screenings, we collected focus group and questionnaire data from 48 participants aged 60 years and older at baseline and 6-month follow-up. The video educated, encouraged, and activated older people around issues such as independence, physical activity and social connectedness. We encourage researchers to adopt KT strategies – and to use evidence-informed video – that older adults can relate to and critically engage with on an accessible, emotional, and intellectual level.
Which neighbourhood factors most consistently impact on depression and anxiety remains unclear. This study examines whether objectively obtained socioeconomic, physical and social aspects of the neighbourhood in which persons live are associated with the presence and severity of depressive and anxiety disorders.
Methods
Cross-sectional data are from the Netherlands Study of Depression and Anxiety including participants (n = 2980) with and without depressive and anxiety disorders in the past year (based on DSM-based psychiatric interviews). We also determined symptom severity of depression (Inventory of Depression Symptomatology), anxiety (Beck Anxiety Inventory) and fear (Fear Questionnaire). Neighbourhood characteristics comprised socioeconomic factors (socioeconomic status, home value, number of social security beneficiaries and percentage of immigrants), physical factors (air pollution, traffic noise and availability of green space and water) and social factors (social cohesion and safety). Multilevel regression analyses were performed with the municipality as the second level while adjusting for individual sociodemographic variables and household income.
Results
Not urbanization grade, but rather neighbourhood socioecononomic factors (low socioeconomic status, more social security beneficiaries and more immigrants), physical factors (high levels of traffic noise) and social factors (lower social cohesion and less safety) were associated with the presence of depressive and anxiety disorders. Most of these neighbourhood characteristics were also associated with increased depressive and anxiety symptoms severity.
Conclusion
These findings suggest that it is not population density in the neighbourhood, but rather the quality of socioeconomic, physical and social neighbourhood characteristics that is associated with the presence and severity of affective disorders.